MANAGEMENT OF GASTROINTESTINAL HEMORRHAGE OF UNDETERMINED ORIGIN

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Abstract
This case is reported to illustrate a principle that has proved of value in the management of massive hemorrhage from the gastrointestinal tract in cases in which the cause of bleeding cannot be discovered by exhaustive studies. In such instances, we believe that exploratory laparotomy should be looked on as a diagnostic procedure, but, to discover the bleeding site, the operation must be performed during the episode of active bleeding. The frequency with which the origin of manifest gastrointestinal hemorrhage is not revealed by meticulous and comprehensive studies varies considerably in reported series (from 2 to 30%). The explanation for this may lie in one or more of the following factors: (1) an inaccurate or incomplete history; (2) overlooking a significant physical finding; (3) incomplete or inaccurate laboratory observations on liver function, blood dyscrasias, and bleeding mechanisms; (4) inadequately performed roentgen studies of the gastrointestinal tract, e. g., failure to

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