Diagnostic yield of endoscopy in upper gastrointestinal bleeding.

On a total of 934 fibreoptic oesophagogastroduodenoscopies, performed between September, 1978 and September 1981, 122 patients presented with symptoms of upper gastrointestinal bleeding of less than two weeks duration. The most frequent findings were peptic ulcer (40.9%), oesophageal varices (16.4%) and mucosal lesions (7.4% as an isolated finding and a further 16.4% associated with peptic ulcer or varices). Negative endoscopies comprised 24.6% of all 122 patients, but in 19 in whom the bleeding episode preceded the endoscopy by not more than 48 hours, there were none. In 105 patients whose history of haematemesis and/or melaena was not recent, endoscopy was negative in 30%, but in patients without such history in 50%. Haematemesis and melaena are important symptoms and add weight to the indication for endoscopy. The earlier the endoscopy can be done, the greater is the diagnostic yield.