Haematemesis from gastric ulcer : notes on over two hundred cases / by W. Gilman Thompson.

  • Thompson, W. Gilman (William Gilman), 1856-1927.
Date:
1905
Catalogue details

Licence: In copyright

Credit: Haematemesis from gastric ulcer : notes on over two hundred cases / by W. Gilman Thompson. Source: Wellcome Collection.

Provider: This material has been provided by The Royal College of Surgeons of England. The original may be consulted at The Royal College of Surgeons of England.

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    Extracted from the American Journal of the Medical Sciences, September, 1905 14 Hr A HdEMATEMESIS FROM GASTRIC ULCER; NOTES ON OVER TWO HUNDRED CASES.1 By W. Gilman Thompson, M.D., 6F NEW YORK. The present inquiry was undertaken with the view of formulating the indications for operation in cases of gastric ulcer. The cases have been collected from the records of the Presbyterian and Belle- vue Hospitals, and from private sources, numbering collectively more than 200. During the past sixteen years there have been treated at the Presbyterian Hospital 195 cases in which the diagnosis of gastric ulcer has been made, including 167 females and 28 males—a pro- portion of 6 to 1. The most interesting feature of these cases is the fact that so large a number, considerably more than one-half, were discharged as “cured” after serious haematemesis which occurred either imme- diately before admission or during the patient’s stay in the hospital, or both. The exact figures are as follows: lliematemesis: ” Cured ” under medical treatment . . . .111 Improved “ “ .... 19 Unimproved “ “ .... 3 Died “ .... 41 Melsena without hsematemesis 1 Ulcer without haematemesis (cured) 20 195 The total deaths, numbering 41, present a ratio of 1 death to 4.8 cases. Included in the deaths which took place among the unoperated cases were several in which the ulcer was not the whole cause; thus half a dozen patients died from pneumonia, 1 with abscess of the pancreas, 1 with pyonephrosis, 1 with pyopneumothorax, and 3 with a subphrenic abscess. One patient had a gastroureteral fistula. In 8 of the unoperated cases and in 3 of the 20 which were operated upon, the patients died from the immediate effects of hemorrhage into the stomach, which was found at autopsy filled with blood. In 1 case, for example, the patient lost eighty ounces of