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July 1990

Gastric Lavage in Patients With Gastrointestinal Hemorrhage: Yea or Nay?

Author Affiliations

Division of Gastroenterology Department of Medicine University of California at San Diego San Diego, CA 92103

Arch Intern Med. 1990;150(7):1379-1380. doi:10.1001/archinte.1990.00390190045004

For centuries, physicians have used gastrointestinal tubes to study gastrointestinal physiology and pathophysiology.1 One of the unblemished icons of medicine is the placement of a nasogastric or orogastric tube to examine the gastric contents in patients with, or suspected of, upper gastrointestinal hemorrhage2-4 and, in turn, "determine" whether the patient is bleeding actively, based on the contents of the gastric aspirate.

See also p 1381.

In this issue of the Archives, Cuellar et al5 attempt to address the usefulness of nasogastric aspiration in predicting those cases where there is a suspicion of active bleeding from an upper gastrointestinal source. Does examination of the gastric contents in patients with the diagnosis of active upper gastrointestinal hemorrhage assist in predicting the likelihood of acute bleeding?

The steps involved in physicians' clinical decisionmaking processes have been examined.6 Often, the first line in the decision-tree algorithm is related to personal and/or

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