Diagnostic accuracy of fiberoptic panendoscopy and visceral angiography in acute upper gastrointestinal bleeding.

Emergency fiberoptic panendoscopy and visceral angiography both had comparable diagnostic accuracy in our series of 55 patients with actively bleeding upper gastrointestinal lesions. The diagnostic accuracy of the barium meal was found inferior to both fiberoptic panendoscopy and visceral angiography. Panendoscopy proved capable of quickly and safely diagnosing site and source of the active bleeding lesion. Visceral angiography requiring additional time, expense and personnel commitment proved an effective back-up procedure when panendoscopy was unsuccessful or contradictions existed. Emergency angiography was well tolerated by gravely ill patients. The therapeutic advantage of angiography with infusion of vasopressin upon completion of the diagnostic study remains to be shown as an advantage over panendoscopy.