Early or delayed endoscopy for patients with peptic ulcer bleeding. A prospective randomized study.

Abstract:

:The benefit of early endoscopy in the management of peptic ulcer bleeding remains controversial. In this study we looked at the role of early endoscopy in bleeding peptic ulcer patients with clear, "coffee grounds," or bloody nasogastric aspirate. A consecutive series of 325 patients with peptic ulcer bleeding were included (218 patients with clear aspirate, 77 patients with coffee-grounds aspirate, and 30 patients with bloody aspirate). They were randomized to receive early endoscopy (within 12 h of arrival at the emergency room) or delayed endoscopy (12 h after arrival at the emergency room). Early endoscopy did not benefit patients with clear or coffee-grounds aspirate. However, combined with endoscopic therapy, it did significantly benefit patients with bloody aspirate in reducing the need for blood transfusion (mean, 450 ml vs. 666 ml; p < 0.001) and hospital stay (mean, 4 vs. 14.5 days, p < 0.001). Early endoscopy and endoscopic therapy are not needed in bleeding peptic ulcer patients with clear or coffee-grounds nasogastric aspirate. However, early endoscopy and endoscopic therapy benefit patients with bloody nasogastric aspirate.

journal_name

J Clin Gastroenterol

authors

Lin HJ,Wang K,Perng CL,Chua RT,Lee FY,Lee CH,Lee SD

doi

10.1097/00004836-199606000-00005

subject

Has Abstract

pub_date

1996-06-01 00:00:00

pages

267-71

issue

4

eissn

0192-0790

issn

1539-2031

journal_volume

22

pub_type

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