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Related Experiment Videos

Endoscopy for upper gastrointestinal bleeding at emergency unit.

C F Chang1, C Y Chan, H J Lin

  • 1Department of Medicine, Veterans General Hospital-Taipei, Taiwan, R.O.C.

Zhonghua Yi Xue Za Zhi = Chinese Medical Journal; Free China Ed
|April 1, 1992
PubMed
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This study highlights upper gastrointestinal endoscopy (UGIE) as a key diagnostic tool for hematemesis and melena. Esophageal varices (EV) showed higher mortality than gastric/duodenal ulcers (GU/DU).

Area of Science:

  • Gastroenterology
  • Internal Medicine
  • Emergency Medicine

Background:

  • Upper gastrointestinal (GI) bleeding, presenting as hematemesis or melena, is a common emergency unit presentation.
  • Timely diagnosis and management are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic yield and therapeutic implications of upper gastrointestinal (UGI) endoscopy in patients presenting with acute GI bleeding.
  • To compare the clinical characteristics and outcomes of different causes of UGI bleeding, including gastric ulcers (GU), duodenal ulcers (DU), and esophageal varices (EV).

Main Methods:

  • A retrospective analysis of 381 patients presenting with hematemesis or melena to an emergency unit over a three-month period.
  • Upper gastrointestinal (UGI) endoscopy was performed on 298 patients, with diagnoses categorized as GU, DU, EV, or others.

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  • Outcomes, including endoscopic therapies, need for surgery, and mortality rates, were analyzed.

    • Main Results:

    • UGI endoscopy diagnosed gastric ulcer (33.6%), duodenal ulcer (32.7%), and esophageal varices (17.0%) in 330 patients, with a high diagnostic rate of 98.8%.
    • Patients with esophageal varices had a significantly higher mortality rate (19.6%) compared to those with gastric/duodenal ulcers (1.8%).
    • Early endoscopy (within 6 hours) was associated with higher frequencies of stigmata of recent hemorrhage and more endoscopic therapies.

    Conclusions:

    • Upper gastrointestinal (UGI) endoscopy is highly effective in diagnosing the source of acute upper GI bleeding.
    • Esophageal varices represent a more severe condition with higher mortality risk than peptic ulcers.
    • Prompt endoscopic intervention can improve outcomes for patients with bleeding peptic ulcers.