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April 1973

Gastroduodenal EndoscopyManagement of Acute Upper Gastrointestinal Hemorrhage

Author Affiliations

From the Department of General Surgery (Drs. Allen and Block) and the Division of Gastroenterology (Dr. Schuman), Henry Ford Hospital, Detroit.

Arch Surg. 1973;106(4):450-455. doi:10.1001/archsurg.1973.01350160068011

During a period of 20 months, 101 patients underwent gastroduodenal endoscopy for acute upper gastrointestinal tract hemorrhage. Of these, the study was performed within 48 hours in 77 patients, providing a positive diagnosis of the original lesion in 69 patients (90%). A positive diagnosis was established for only eight (33%) of the 24 patients studied later than 48 hours. Standard radiologic studies with barium indicated a possible cause for bleeding in only 38 (54%) of the 71 patients studied within 48 hours, but correctly identified the actual cause for hemorrhage in only 23 (32%). Endoscopy resulted in only one false positive diagnosis. A previous diagnosis or historical data suggested a cause for bleeding in 61 of the 101 patients, but was correct in only 35 (57%). Massive bleeding prevented endoscopy in two patients, and technical factors limited the examination in four.