Early or delayed endoscopy for patients with peptic ulcer bleeding: A prospective randomized study

Hwai Jeng Lin, Kun Wang, Chin L. Perng, Rudy Tan Chua, Fa Yauh Lee, Chen Hsen Lee, Shou Doug Lee

Research output: Contribution to journalArticle

124 Citations (Scopus)


The benefit of early endoscopy in the management of peptic ulcer bleeding remains controversial. In this study we looked at the role of early endoscopy in bleeding peptic ulcer patients with clear, 'coffee grounds,' or bloody nasogastric aspirate. A consecutive series of 325 patients with peptic ulcer bleeding were included (218 patients with clear aspirate, 77 patients with coffee-grounds aspirate, and 30 patients with bloody aspirate). They were randomized to receive early endoscopy (within 12 h of arrival at the emergency room) or delayed endoscopy (12 h after arrival at the emergency room). Early endoscopy did not benefit patients with clear or coffee-grounds aspirate. However, combined with endoscopic therapy, it did significantly benefit patients with bloody aspirate in reducing the need for blood transfusion (mean, 450 ml vs. 666 ml; p <0.001) and hospital stay (mean, 4 vs. 14.5 days, p <0.001). Early endoscopy and endoscopic therapy are not needed in bleeding peptic ulcer patients with clear or coffee-grounds nasogastric aspirate. However, early endoscopy and endoscopic therapy benefit patients with bloody nasogastric aspirate.

Original languageEnglish
Pages (from-to)267-271
Number of pages5
JournalJournal of Clinical Gastroenterology
Issue number4
Publication statusPublished - Jun 1996
Externally publishedYes



  • Bloody aspirate
  • Clear aspirate
  • Coffee-grounds aspirate
  • Early endoscopy
  • Peptic ulcer bleeding

ASJC Scopus subject areas

  • Gastroenterology

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