Combined Endoscopy in Upper Gastrointestinal Haemorrhage

Summary: Combined endoscopic examination was performed in 206 patients presenting with upper gastrointestinal haemorrhage. This represents 92% of all patients admitted with this emergency to one hospital over a 12 month period. Endoscopy achieved a diagnosis of the cause of bleeding in 92% of patients. The causes were: Pyloroduodenal ulcer 32%, haemorrhagic gastritis and gastric erosions 23%, gastric ulcer 20%, oesophageal varices 6%, Mallory Weiss lesion 5%, haemorrhagic duodenitis 5%, gastric carcinoma 4%, miscellaneous causes 5%. Combined lesions were found in 12% of patients. Follow up assessment revealed endoscopy to be an accurate investigation. The mortality for the series was 4.8%. Half the deaths resulted from bleeding oesophageal varices with advanced liver disease. It is suggested that because of its accuracy and high diagnostic yield, early endoscopy may replace contrast radiography as the first investigation in upper gastrointestinal haemorrhage.