Gastroduodenal endoscopy. Management of acute upper gastrointestinal hemorrhage.

Abstract

During a period of 20 months, 101 patients underwent gastroduodenal endoscopy for acute upper gastrointestinal tract hemorrhage. Of these, the study was performed within 48 hours in 77 patients, providing a positive diagnosis of the original lesion in 69 patients (90%). A positive diagnosis was established for only eight (33%) of the 24 patients studied later than 48 hours. Standard radiologic studies with barium indicated a possible cause for bleeding in only 38 (54%) of the 71 patients studied within 48 hours, but correctly identified the actual cause for hemorrhage in only 23 (32%). Endoscopy resulted in only one false positive diagnosis. A previous diagnosis or historical data suggested a cause for bleeding in 61 of the 101 patients, but was correct in only 35 (57%). Massive bleeding prevented endoscopy in two patients, and technical factors limited the examination in four.