Urgent endoscopy
Urgent upper gastrointestinal tract endoscopy is indicated in people with bleeds. Ideally it should be:
- combined with resuscitation of the patient
- conducted in a site with full facilities
- within 18 hours of the start of the bleed
Problems in the acute situation include:
- failure to intubate
- misinterpretation of endoscopic images
- risk to the patient and to the endoscopic equipment
Stigmata of a recent bleed include:
- a clot in an ulcer base } if these are present there
- oozing blood } is a 50% likelihood of a
- a visible vessel } rebleed; without it is 5%
Procedures available to the endoscopist include Yag laser, topical sprays, contact probes and injection.
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