What is the role of esophagogastroduodenoscopy (EGD) in the workup of lower gastrointestinal (GI) bleeding (LGIB)?

Updated: Jul 26, 2019
  • Author: Burt Cagir, MD, FACS; Chief Editor: BS Anand, MD  more...
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Answer

An esophagogastroduodenoscopy (EGD) is performed if a nasogastric (NG) tube aspirate is positive for blood, because about 10% of patients presenting with lower gastrointestinal bleeding (LGIB) have bleeding originating from the upper GI tract. Small bowel endoscopic procedures are usually performed after EGD, colonoscopy, radionuclide scans, and angiography have been used and the bleeding site remains not localized. If the NG tube aspirate reveals bile, upper GI bleeding is practically excluded. There may be a role for EGD in a small group of patients who has both hemoglobin- and bile-negative NG tube aspirates.


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