ABSTRACT
Peptic ulcer is the most common diagnosis amongst patients presenting with acute upper gastrointestinal haemorrhage: large observational studies (1) have consistently shown those with peptic ulcer to comprise approximately 50% of all cases (Table 11.1.1). The management pathway of an acute upper gastrointestinal haemorrhage is the same for all patients until a diagnosis has been made, at which point more specific management policies may be relevant, such as the injection of a bleeding vessel in peptic ulceration, or banding of oesophageal varices (see Chapter 11.2). From a practical point of view, the cause of bleeding remains obscure until upper gastrointestinal endoscopy has been undertaken. Even after oesophagogastroduodenoscopy, the source of bleeding may be obscure as a result of a missed lesion, a more distal lesion, or because a wrong diagnosis of gastrointestinal haemorrhage was made.
