Portal de Periódicos da CAPES

The British Society of Gastroenterology

1979; BMJ; Volume: 20; Issue: 5 Linguagem: Inglês

10.1136/gut.20.5.a433

1468-3288

N. J. Mortensen, Elizabeth Lambert, D C Britton, Kevin Gough, Jon Walker, J. S. M. Beales, Richard Allan,

Colorectal Cancer Screening and Detection

The value of urgent endoscopy in upper gastro- intestinal bleeding is controversial because recent papers have indicated that it has little effect on mortality, although diag- nostic accuracy is improved.A study was undertaken to assess the benefits of this expensive, time-consuming service in a district general hospital.Two years were reviewed: 1973 when no en- doscopy service was available, and 1976 when all bleeders were endoscoped.In 1976 diagnostic accuracy was achieved in 85% of 145 patients; 15 patients subsequently died (10%).In 1973, 158 patients were admitted with acute gastro- intestinal bleeding.A radiological diag- nosis was made (on that admission) in 54 (34%/); 12 patients subsequently died (7.5 Y.).Increased diagnostic accuracy in this hospital has not affected the numbers coming to emergency surgery, or the overall mortality.Until the management of acute gastro- intestinal bleeding is modified by therapeutic endoscopy, it is difficult to justify the expense of preoperative emergency A433diagnostic endoscopy.In selected patients it may have a place during emergency surgery to identify a bleeding point.