ENDOSCOPY IN GASTROINTESTINAL BLEEDING

Abstract

The results of early endoscopy in patients with upper-gastrointestinal-tract bleeding, referred to the gastrointestinal service of a large general hospital, were reviewed. 111 endoscopies were carried out in a hundred and six patients. A source of active or recent bleeding was identified in 56 (50·3%) instances; in 38% of these an additional non-bleeding lesion was found. Success in identifying the site of bleeding fell rapidly from 78% within 24 hours of admission to 32% after 48 hours. Patients with hæmatemesis were admitted to hospital earlier and had endoscopy more quickly than patients with melæna alone; this probably accounted for the higher endoscopic success-rate in this group. Endoscopy was inadequate in seven (6·3%) cases, and in five (4·5%) others lesions were missed. There was a serious complication in one case (aspiration pneumonia). Emergency endoscopy put a considerable strain on the resources of the hospital's routine gastrointestinal service.