Does early endoscopy benefit the patient with active upper gastrointestinal bleeding?
Eastwood, G.L.
Gastroenterology 72(4 Pt 1): 737-739
1977
ISSN/ISBN: 0016-5085 PMID: 320085 Document Number: 115440
The rapid development and utilization of fiberoptic endoscopy over the past decade has markedly enhanced the ability to diagnose correctly many disorders of the gastrointestinal system. Prompt endoscopy has been enthusiastically embraced by physicians who care for actively bleeding patients. The reasonable anticipation was that an early, correct diagnosis would lead to reduced morbidity and mortality. Four prospective controlled trials which attempt to compare the early endoscopic approach with less aggressive approaches to upper gastrointestinal bleeding are discussed. No one questions the diagnostic superiority of endoscopy over other methods of diagnosis. The issue is simply whether the superior diagnostic accuracy of endoscopy confers any therapeutic advantage which will ultimately lead to reduced morbidity and improved survival. Until the definitive study appears, the physician who chooses not to endoscope every patient with active upper gastrointestinal bleeding will not be condemned by the evidence currently available.