Retrograde intraoperative gastroscopy in obscure bleeding of the gastrointestinal tract

Intraoperative endoscopic localization of the lesions responsible for the bleeding in the upper part of the gastrointestinal tract that escape detection in the preoperative period is an attractive alternative to the blind exploratory duodenogastrostomy. The retrograde technique described herein may be superior to the oral antegrade intraoperative method advocated by some authors. Large clots obscuring clear viewing are rapidly removed by way of the small gastrotomy, and the proximal hidden corners of the stomach are readily visualized even by a surgeon who lacks previous experience with endoscopic techniques. We suggest this to be the method of choice for localization of the obscure point of bleeding during emergent operations for bleeding of the upper part of the gastrointestinal tract.