[The value of diagnostic and interventional endoscopy in acute, non-varicose, upper gastrointestinal hemorrhage]

There is a broad consensus about the benefits of emergency endoscopy in the diagnosis and treatment of acute upper gastrointestinal bleeding. The Wels General Hospital is a large teaching hospital where all emergency endoscopies are performed by the staff of the First Department of Internal Medicine. The reports of 11,078 esophagogastro-duodenoscopies performed between November 1987 and February 1993 were scrutinized by the authors and 980 cases identified where a clinical diagnosis of suspected upper gastrointestinal hemorrhage had been made. All together 156 patients showed signs of active or recent bleeding on endoscopy (Forrest Ia, Ib, IIa) and were selected as database for this analysis. We identified 64 patients with duodenal ulcers, 43 patients with gastric ulcers and 15 patients with Mallory-Weiss-tears. Erosions, anastomotic ulcers, cancer and so called rare causes (Dieulafoy ulcers, mesenchymal tumors Hemobilia) were identified in 34 patients. Therapeutic endoscopy was performed in 69 patients (44.2%). For hemostatic therapy we used the injection method with epinephrine. 34 patients underwent surgical therapy (13 cases underwent emergency surgery). 10 of 156 patients 10 (6.4%) died secondary to their acute nonvariceal upper gastrointestinal hemorrhage.