The surgical management of bleeding stress XXXX .

@entity1 @entity1066 @entity204 @entity548
The series included 52 @entity1 with @entity548 stress @entity1066 of the stomach and duodenum seen at the Mayo Clinic during a 25-year period. All @entity1 underwent operation for control of @entity548 that was unresponsive to intensive medical therapy. All @entity1066 were superficial and occurred during clinically stressful circumstances. No @entity1 had a history or findings suggestive of pre-existing peptic @entity1066 or imbibation of ulcerogenic substances. Overall operative mortality was 54%, and this rate seemed to be related to multiple factors acting together; @entity1 with multiple predisposing stress factors and those requiring large transfusion volumes (greater than 17 total units) were at greatest risk of @entity204 . Fifty-two @entity1 underwent 60 operative procedures for control of @entity548 . Of the 60 procedures, 23 (38%) failed to prevent rebleeding. Of the 28 @entity1 who died, six (21%) died of @entity548 and five (18%) died of @entity548 as one of many contributing factors. Of eight different procedures performed, near-total to total gastrectomy was the single procedure that was most effective in controlling @entity548 . The authors support the selection of rapid intervention and generous extirpative surgery once intensive medical measures fail to control @entity548 .
