Abstract
Endoscopy plays a major role in the management of acute upper gastrointestinal bleeding (UGIB) as it is currently accepted to be an effective procedure for the reduction of the rate of rebleeding, the need for surgery, and mortality [1]. However, because the safety of a very early endoscopy has been questioned and due to the associated organizational needs and related costs, diverse attempts have been made over the years to determine the best combination of peri- and intra-endoscopy procedures (“how”?), “when” to provide endoscopy, and the patients “to whom” endoscopy must be offered to achieve a cost-effective model of healthcare. It seems, however, that there is still room for improvement. In fact, even the group involved in the most recent recommendations for the management of acute nonvariceal UGIB [2] were only able to include the statements “endoscopy should be recommended within 24 hours of presentation for most patients” and “prognostic scales to stratify patients according to their death and rebleeding risks” should be used.
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