Help
Subscribe


GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy

 20 February 2018

Advanced search
GastroHep.com - the global online resource for all aspects of gastroenterology, hepatology and endoscopy Profile of Roy Pounder

Home

News  
Journals
Review Articles
Slide Atlas
Video Clips
Online Books
Advanced Digestive Endoscopy
Classical Cases
Conference Diary
PubMed
International GH Links
USA GH Links
National GH Links
National GI Societies
Other Useful Links




Emails on Gastroenterology and Hepatology
the National AIDS Treatment Advocacy Project
Visit the gastroenterology section of the EUMS

News

Early versus delayed endoscopy in bleeding peptic ulcers

This month's issue of Endoscopy finds that endoscopy at admission in an emergency room does not improve the clinical outcome in patients with bleeding peptic ulcer as compared with delayed endoscopy occurring within 24 hours.”

News image

fiogf49gjkf04

In previous randomized trials, early endoscopy improved the outcome in patients with bleeding peptic ulcer.

Most of these studies defined “early” as endoscopy performed within 24 hours after admission.

Dr Schacher and colleagues from Switzerland conducted a retrospective analysis of endoscopy done immediately after admission, that is, early endoscopy in the emergency room.

The researchers considered the length of hospital stay as the primary criterion for the clinical outcome.

The research team compared the results of the emergency room endoscopy with endoscopy postponed to a time within the first 24 hours after hospitalization, but still during normal working hours, termed ”delayed” endoscopy in the endoscopy unit.

The investigators included data from 81 consecutive patients with bleeding peptic ulcer that were admitted in 1997 and 1998, between 16 - 90 years of age.

Of these 81 patients, 38 underwent delayed endoscopy, the standard therapy at the hospital, and 43 underwent early endoscopy in the emergency room.

The need for surgery was 8% with delayed endoscopy versus 9% in early endoscopy
Endoscopy

Patients in the 2 groups were comparable with regard to admission criteria and differed only in the treatment they received

The team reported that patients were also equally distributed with respect to their risk of adverse outcome, assessed using the Baylor bleeding score and the Rockall score.

The researchers performed endoscopic hemostasis whenever possible in all patients with Forrest types I, IIa, and IIb ulcer bleeding.

The investigators found similar rates in the two groups for recurrent bleeding, with 16 % in delayed endoscopy patients versus 14 % in early endoscopy patients.

Persistent bleeding occurred in 8 % of patients receiving delayed endoscopy versus none in early endoscopy patients.

The team observed that medical complications were 21 % in delayed endoscopy patient versus 26 % in early endoscopy patients.

In addition, the need for surgery was 8 % in delayed endoscopy patients versus 9 % in early endoscopy patients, and the length of hospital stay was 5 days for delayed endoscopy versus 6 days for early endoscopy.

The investigative team reported that none of the differences between the 2 groups in these parameters were statistically significant and that no patients died.

Dr “Schacher’s team concludes, “Early endoscopy in an emergency room does not improve the clinical outcome in our 81 consecutive patients with bleeding peptic ulcer.”

Endoscopy 2005; 37: 324-328
18 April 2005

Go to top of page Email this page Email this page to a colleague

 20 February 2018 
Complications and surveillance colonoscopies
 20 February 2018 
Treatment algorithm for polyp cancers
 20 February 2018 
Predictors of postoperative infection in Crohn's
 19 February 2018 
Screening colonoscopy in the right and left colon
 19 February 2018 
NAFLD prevalence in the USA
 19 February 2018 
Fructans in children with IBS

 16 February 2018 
Undetected celiac in the elderly
 16 February 2018 
Inflammatory bowel diseases are global diseases
 16 February 2018 
Fructans induce non-celiac gluten sensitivity
 15 February 2018 
NSAIDS and GI damage
 15 February 2018 
Oral direct-acting antiviral treatment for Hep C virus genotype 1
 15 February 2018 
Primary vs secondary surgery for the presence of lymph node metastasis
 14 February 2018 
Predicting adenoma detection rate
 14 February 2018 
Normal bowel frequency characterization in the USA 
 13 February 2018 
Personalising treatment options for IBS
 13 February 2018 
Prebiotics improve endothelial dysfunction
 13 February 2018 
Diagnostic criteria for a Rome IV functional gastrointestinal disorders
 12 February 2018 
Visceral hypersensitivity and functional GI disorders
 12 February 2018 
Depression and aggressive IBD
 12 February 2018 
Variability in interpretation of endoscopic findings impacts patient management
 09 February 2018 
Treatment of choice for anastomotic stricture in IBD
 09 February 2018 
PRO measurement information system 
 09 February 2018 
Overall disease severity indices for IBD
 08 February 2018 
Prediction of endoscopically active disease

 08 February 2018 
Steroid-refractory acute severe ulcerative colitis
 08 February 2018 
Decision aid used by IBD patients
 07 February 2018 
Ursodeoxycholic acid combined with bezafibrate for itching
 07 February 2018 
Change in microbiome in gastritis vs gastric carcinoma
 07 February 2018 
Colorectal cancer and primary sclerosing cholangitis-IBD
 06 February 2018 
Risk of death after liver transplantation
 06 February 2018 
Crohn’s disease vs refractory pouchitis
 06 February 2018 
Support for functional dyspepsia symptom diary
 05 February 2018 
Helicobacter spp influence on GI tract 
 05 February 2018 
No link found between severe reflux and all-cause mortality 
 05 February 2018 
Psychological distress in PPI non-responders
 02 February 2018 
Assessing psychosexual impact of IBD
 02 February 2018 
Decrease in overall mortality with cholera vaccination
 02 February 2018 
Diagnostic performance of fecal immunochemical tests
 01 February 2018 
Screening frequency with family histories of colorectal cancer
 01 February 2018 
IBD and sport participation
 01 February 2018 
Life with a stoma 
 31 January 2018 
Aprepitant and gastroparesis 
 31 January 2018 
Anesthesia risk in colonoscopy
 31 January 2018 
GED-0301 for Crohn's Disease
 30 January 2018 
Intestinal dysbiosis and allergic diseases in infants
 30 January 2018 
Fructans and IBS symptoms in children
 29 January 2018 
Dosing calculator for therapy optimization in IBD
 29 January 2018 
Glecaprevir–pibrentasvir for in HCV
 29 January 2018 
Food allergen injections in eosinophilic esophagitis
 29 January 2018 
Reliability of the IBD index
 26 January 2018 
Tofacitinib vs biological therapies for ulcerative colitis
 26 January 2018 
Optimizing selection of biologics in IBD
 26 January 2018 
Nutritional risk and laparoscopic-assisted gastrectomy outcomes
 25 January 2018 
Patient-reported outcome measure for functional dyspepsia
 25 January 2018 
Predicting intra-abdominal infections after colorectal surgery
 25 January 2018 
Predictors of gastric cancer risk
 24 January 2018 
Risk factors underlying previously undiagnosed cirrhosis
 24 January 2018 
Ethnicity influences phenotype in IBD
 24 January 2018 
Bariatric surgery vs medical obesity treatment
 23 January 2018 
Atrophic gastritis after H. pylori eradication

Blackwell Publishing


GastroHep.com is a Blackwell Publishing registered trademark
© 2018 Wiley-Blackwell and GastroHep.com and contributors
Privacy Statement
Disclaimer
About Us