Massive Intestinal Hemorrhage

Abstract

Often, prompt evaluation of various factors, will enable the physician to decide quite readily whether a patient with massive intestinal hemorrhage is likely to have malignancy, hepatic cirrhosis or a benign process. Determination of blood volume is an important diagnostic procedure and should be done whenever possible; in lieu of this test, serial hematocrit determinations are of value.

Roentgenographic examination usually can be made if the patient is not in shock. The need for careful handling, with a minimum of manipulation, is stressed.

Management of gastrointestinal hemorrhage should be a joint effort. Operation should not be performed in the face of hemorrhage if it can possibly be avoided, but sometimes surgical intervention is necessary. Management of patients with hepatic cirrhosis, particularly, should be ultraconservative, but continued bleeding from esophageal varices may necessitate definitive operative treatment.