Endoscopic therapy for bleeding from the upper gastrointestinal tract.

Advances in endoscopic therapy have dramatically altered the approach to acute upper gastrointestinal tract hemorrhage. It can no longer be assumed that early endoscopic evaluation of this condition does not affect outcome. In the management of selected patients with nonvariceal hemorrhage, endoscopic therapy affects rates of rebleeding, need for surgery and transfusions, and length of hospitalization. For patients with variceal hemorrhage, the impact of endoscopic treatment is less clear. The endoscopic advances of the past decade have been exciting and have presented new challenges. Future investigators need to better define subgroups of patients who will benefit from this technology and determine which of the many techniques available will be safest and most efficacious.