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Prospective, randomized study of diagnosis and outcome in acute upper-gastrointestinal bleeding: Endoscopy versus conventional radiography

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Abstract

Sixty patients with mild to moderate upper-gastrointestinal bleeding were admitted to a prospective, controlled study of diagnosis and management, and were randomized to endoscopy or upper-gastrointestinal (UGI) barium series as the initial study. Definitive localization of the source of bleeding was made initially in 69% of the endoscopy group and 21% of the UGI group (P<0.0005). Of 54 patients undergoing both studies, endoscopy was definitive in 67% and UGI series in 22%. Thus, endoscopy also made more diagnoses when used as the second study (P<.01). The use of endoscopy as the initial procedure led to significantly more rapid diagnosis than with UGI series. However, there were no significant differences between the two groups in clinical outcome. Endoscopy is the initial diagnostic procedure of choice in patients with mild to moderate upper-gastrointestinal bleeding because it enables detection of superficial bleeding lesions and has significantly increased the speed of diagnosis.

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Author information

Correspondence to Dr. Gary M. Levine MD.

Additional information

The following are members of the Gastrointestinal Section of the University of Pennsylvania. Staff: Drs. Frank P. Brooks, Sidney Cohen, Julius J. Deren, Anthony J. DiMarino, Jr., William B. Long, Geobel A. Marin, J. Donald Ostrow, Roger D. Soloway, Bruce W. Trotman, and Jordan W. Weiss.

Trainees: Drs. Dominic Comperatore, Thomas J. Devers, Robert G. Knodell, Gary M. Levine, John R. Mathias, David W. Morris, Stewart D. Shull, William J. Snape, Jr., Monroe H. Spector, Edward J. Tapper, and Charles I. Wagner.

Supported in part by a National Institutes of Health training grant (AMO5462) and a Veterans Administration training grant (TR15).

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Morris, D.W., Levine, G.M., Soloway, R.D. et al. Prospective, randomized study of diagnosis and outcome in acute upper-gastrointestinal bleeding: Endoscopy versus conventional radiography. Digest Dis Sci 20, 1103–1109 (1975). https://doi.org/10.1007/BF01070752

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Keywords

  • Public Health
  • Clinical Outcome
  • Barium
  • Diagnostic Procedure
  • Initial Study