[The surgical and endoscopic therapeutic procedures in acute hemorrhages of the upper digestive tract].

A total of 2995 patients with esophagogastroduodenal bleeding have been treated the Department of Emergency Surgery for the period 1984-1988. A significant group were patients in advanced and senile age (beyond 65--42.4 per cent). The therapeutic and surgical approach to gastroduodenal bleeding was based on the solution of the following diagnostic-tactic problems: cause, source, localization and intensity of the bleeding, temporary or definitive hemostasis patterns, severity of blood loss. Essential is also the underlying disease, patient age and accompanying diseases. Express emergency endoscopy allows early and explicit visualization of the pathologic area and enables to gain knowledge on the nature and intensity of the bleeding or the character of spontaneous hemostasis. In this respect, express endoscopy is a guiding principle in managing upper digestive tract bleeding at the Department of Emergency Surgery. Of all hospitalized patients in this study were operated 203. Operations were performed after obligatory attempt for endoscopic hemostasis. The operative case fatality rate for the study period was, as follows: in gastric and duodenal ulcer 21.6 per cent, in gastric cancer 42.0 per cent, in hemorrhagic gastritis 33.3 per cent and in Mallory-Weiss syndrome 9.1 per cent.