RT Journal
A1 Blackstone MO, Kirsner JB
T1 EStablishing the site of gastrointestinal bleeding
JF JAMA
JO JAMA
YR 1979
FD February 9
VO 241
IS 6
SP 599
OP 599
DO 10.1001/jama.1979.03290320041030
UL http://dx.doi.org/10.1001/jama.1979.03290320041030
AB Traditionally, aspiration of gastric contents for blood is employed as the initial step in the diagnosis of gastrointestinal (GI) bleeding.1 A positive result is usually viewed as indicating a bleeding site proximal to the ligament of Treitz, while negative aspirate implies a lower (small bowel or colon) site. Despite its intuitive correctness, the clinical value of this test never has been fully established. The article by Luk and colleagues, which appears elsewhere (p 576) in The Journal, attempts to do this. In their study the outcome in 1,190 patients who had gastric aspiration performed was analyzed as to the site of bleeding ultimately determined. All patients in the study had undergone a vigorous attempt to define the site of bleeding. Upper GI endoscopy was employed in almost all patients and was the initial procedure in those having a gastric aspirate positive for blood (gross blood or guaiac-positive material). Sigmoidoscopy,