Diagnosis Methods for Upper Gastrointestinal Bleeding

Upper gastrointestinal bleeding is primarily diagnosed based on medical history, symptoms, and clinical examinations. The following diagnostic procedures are commonly used:

Laboratory Tests

Blood tests including platelet count, coagulation time, complete blood count (CBC), prothrombin time, and blood ammonia levels are essential. These tests help differentiate bleeding caused by esophageal varices due to liver cirrhosis from other causes. They also provide insight into the patient's overall health and clotting ability.

Swallowed Thread Test or Fluorescein Swallowed Thread Test

This method involves using a thread that is swallowed by the patient. The thread may become stained or marked by the site of bleeding in the digestive tract, helping doctors determine the general location of the hemorrhage. This technique is especially useful when other diagnostic tools are not immediately available.

Nuclear Medicine Imaging

Radioisotope scanning is an effective way to detect active bleeding. By tracing radioactive material in the bloodstream, this imaging technique can pinpoint the source of bleeding even when it is intermittent or slow.

Selective Angiography

This procedure is particularly valuable for identifying bleeding sites caused by vascular abnormalities such as dilated blood vessels, arteriovenous malformations, vascular tumors, or fistulas. It is often used in emergency situations when endoscopy has failed to locate the source of bleeding and the hemorrhage continues.

Endoscopic Examination

Endoscopy is considered the gold standard for diagnosing upper gastrointestinal bleeding. It allows direct visualization of the bleeding site and the nature of the lesion, enabling both diagnosis and potential therapeutic intervention in a single procedure.

Barium Studies

Barium Meal and Double-Contrast Imaging

Barium X-ray examinations, especially when using a double-contrast technique, significantly improve diagnostic accuracy. These studies can reveal structural abnormalities such as ulcers, tumors, or varices that may be responsible for the bleeding.