Upper gastrointestinal haemorrhage in portal hypertension. Is an emergency endoscopy necessarily required?

Early fibre-optic oesophago-gastroduodenoscopy was performed in 23 portal hypertensive patients with acute upper gastrointestinal haemorrhage to evaluate the source of bleeding. Oesophageal varices grade II or more were documented in all patients. None of the patients showed a source of bleeding other than the ruptured oesophageal varices, probably because, unlike western countries, the alcoholic cirrhosis as a source of portal hypertension is rather uncommon in India. Hence, we could presume that most of the emergency endoscopies are unnecessary in bleeding patients with portal hypertension.