A prospective comparative trial is reported between the results of early endoscopy and barium meal examinations in 150 patients admitted with acute upper gastrointestinal haemorrhage. One hundred and thirty-eight patients underwent both investigations within 24 hours of admission. Emergency endoscopy accurately identified the source of haemorrhage in 86% of patients and emergency radiology identified the source in 51%. Misleading positive reports were given endoscopically in 3% and by barium meal in 8%. The identification of the source of haemorrhage was possible in 126 patients (91%) by the use of both methods. Emergency endoscopy is shown to be superior to emergency barium meal examination, but the examinations are complementary and both should be used for these patients.
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