[Value of endoscopic examination in upper digestive hemorrhage with shock states]

The authors analyze the contribution of endoscopic examination to the aetiological diagnosis and therapeutical approach in upper digestive haemorrhage (UDH), with haemorrhagic shock. In 10 of 34 emergency endoscopic examinations performed over a 2 year period, the patients had a systolic blood pressure of 60 to 90 mm Hg, and were put under the protection of volaemia reequilibration. Endoscopic examination at the patient's bedside in the Anaesthesia-Intensive Care Unit was well tolerated by the patients. In 6 cases the aetiologic diagnosis of UDH was exclusively established on the basis of endoscopic findings. The endoscopic diagnosis was confirmed intraoperatively in 8 of 10 cases. Endoscopy should be performed early, often in full haemorrhage, since it permits adequate treatment and an improved prognosis.