Gastrointestinal bleeding. Endoscopic diagnosis.

Emergency endoscopy is the most accurate method of diagnosis in acute upper gastrointestinal haemorrhage. As yet this increased diagnostic accuracy has not been shown to affect the final outcome and a double-contrast barium meal is almost as accurate in the diagnosis of chronic lesions. Nevertheless, the decision to operate on a bleeding patient is difficult to make without a diagnosis and this is most accurately made initially by endoscopy followed by angiography or a barium meal when necessary.