INFECTION AS A CAUSE OF MASSIVE HEMORRHAGE IN CHRONIC PEPTIC ULCER: REPORT OF FIVE CASES

This communication is a report of 5 cases of death from hemorrhage due to infection in chronic gastric and duodenal ulcers. They were among the last 7 cases of exsanguinating hemorrhage from ulcer observed in the past seven and one-half years at the New York City Hospital, Welfare Island. In each of the 5 cases the criteria of chronicity were answered—distortion of the architectural pattern of the wall, fibrosis of the base of the ulcer and some degree of chronic inflammatory cellular reaction. In all cases bacteria were demonstrated in the sections at the point of hemorrhage. Clinical evidence in some of the cases proved the presence of septicemia. REPORT OF CASES Case 1. —A white man 71 years old was admitted to the surgical division of the City Hospital, service of Dr. A. S. Morrow, on May 29, 1932, in profound shock. He gave a history of vomiting a