Surgical treatment of upper alimentary bleeding.

The place of surgery in the management of patients with bleeding into the stomach or duodenum is largely governed by two aspects of the haemorrhage: the total volume of blood lost and the rate of bleeding. Other factors which are of importance are the cause of the bleeding and the age of the patient. Severe bleeding is one of the most demanding emergencies, and the decision may need to be made rapidly and the operation performed with dispatch. Fortunately most upper alimentary bleeding settles with conservative management and in only a minority of cases does immediate operation have to be considered. However, in all cases the question of surgery to prevent recurrence of the bleeding ought to be considered.