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[Emergency endoscopy in upper gastrointestinal hemorrhage].

P Giorgio1, D Lorusso, F Scotto

  • 1Istituto di Ricovero e Cura a Carattere Scientifico, Specializzato in Gastroenterologia S. de Bellis, Castellana Grotte, Bari.

Minerva Dietologica E Gastroenterologica
|October 1, 1990
PubMed
Summary

Emergency esophagogastroduodenoscopy (EGDS) within 48 hours accurately diagnoses upper gastrointestinal bleeding. Duodenal ulcers were the most common cause, even in cirrhotic patients where esophageal varices were often associated with other lesions.

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Area of Science:

  • Gastroenterology
  • Endoscopy
  • Hepatology

Background:

  • Upper gastrointestinal bleeding (UGIB) is a common medical emergency.
  • Timely diagnosis is crucial for effective management and improved patient outcomes.

Purpose of the Study:

  • To evaluate the diagnostic accuracy and clinical utility of emergency esophagogastroduodenoscopy (EGDS) in patients with UGIB.
  • To identify the primary causes of UGIB and assess outcomes in a large patient cohort.

Main Methods:

  • A retrospective analysis of 236 patients undergoing emergency EGDS within 48 hours of hospital admission for UGIB.
  • Data collected included diagnostic yield, bleeding source, management interventions, and 30-day mortality.

Main Results:

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  • EGDS achieved a definitive diagnosis in 98.7% of cases.
  • Duodenal ulcer was the most frequent cause of bleeding, followed by esophageal varices.
  • In cirrhotic patients, esophageal varices were associated with other lesions in over 50% of cases.
  • Surgery was required in 6.4% of patients, with a 30-day mortality rate of 5.5%.

    • Conclusions:

    • Emergency EGDS is a highly precise diagnostic tool for UGIB, with a high diagnostic yield.
    • Understanding the etiology of UGIB, including associated lesions in cirrhotic patients, is vital for treatment.
    • Early endoscopic intervention significantly impacts patient management and survival in UGIB.