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The History of the Treatment of Hemorrhage from the Digestive Tract H. Okabe 1 1Department of Internal Medicine, Kitasato University School of Medicine pp.705-709
Published Date 1980/7/25
DOI https://doi.org/10.11477/mf.1403112660
  • Abstract
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 Emergency surgical operation has hitherto been the only active way to arrest acute massive hemorrhage from the digestive tract. It is the most reliable measure to control bleeding as well. However, in patients with concomitant other diseases or complications it is too invasive to permit sure and safe operation. At present, the surgical intervention itself can be too dangerous at times. Bleeding cannot be well controlled and not all the patients could be rescued from losing their lives.

 On the other hand, in accordance with the assured status of emergency endoscopic examination and selective angiography of the abdominal arteries, nonsurgical active stanching by these means, invented one after another, is becoming effective. Special attention is now given to it both at home and abroad. In Japan, where fiberscopic diagnosis is most widely adopted, special interest is displayed. Although the medical history about hemorrhage of the digestive tract goes back to ancient times, even to the oldest book of medicine, its treatment other than surgical operation had not made much progress. Propagation of fast and accurate diagnosis by applying emergency endoscopy has been expected to show good results in mortality. However, according to the foreign literature the results of leading institutions using emergency endoscopy show that during the recent 20 years the mortality has not been lowered. Nonetheless, progress and propagation of non-surgical methods of arresting hemorrhage have just started, and we are sure it will prove more effective in the near future.

 Control of bleeding by endoscopic electrocoagulation or laser coagulation and angiographic embolism has not been completed yet, but in some institutions it is beginning to show excellent results. It is now fully expected to lead to control of bleeding in patients too risky to be operated on or those in need of emergency operation and thus to the lowering of mortality.


Copyright © 1980, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 1882-1219 印刷版ISSN 0536-2180 医学書院

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