Bleeding ulcer

A review is presented on theory and practice in the handling of gastroduodenal bleeding in the presurgical era with emphasis on the Meulengracht treatment. A description is thereafter given of the development of criteria for emergency surgery in the preendoscopic period with special mention of the circulatory evaluation using measurements of central venous pressure. A survey is given on the development in endoscopic diagnosis and treatment with a critical evaluation of the predictive value of clinical factors and endoscopic stigmata of haemorrhage. Finally the sparse knowledge on the haemostatic mechanisms of current endoscopic therapies is presented.