Upper GI Bleed (Nonvariceal) — ESEGH MCQ

Instant feedback + full explanation. One question, done properly.

Easy"Gastroenterology"Upper GI Bleed (Nonvariceal)ESEGH

A 62-year-old with an upper gastrointestinal bleed (nonvariceal, suspected) has been resuscitated and is now haemodynamically stable. Which endoscopy timing is generally recommended?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Within 12–24 hours after haemodynamic resuscitation

For nonvariceal upper gastrointestinal bleeding in haemodynamically stable post-resuscitation patients, current UK (NICE CG141) and European (ESGE 2021) guidance recommends endoscopy within 24 hours of admission. Endoscopy must always follow adequate resuscitation (ruling out A). Very early (<6 h) endoscopy is not recommended and may worsen outcomes; early endoscopy (≤24 h) is the standard, supported by RCT evidence showing no mortality or rebleeding benefit from urgent over early procedures. Option C is unacceptably delayed. Option D incorrectly denies endoscopy to stable patients—endoscopy is mandatory for diagnosis and haemostasis regardless of haemodynamic status. Option E applies a transfusion threshold, not an endoscopy indication; haemoglobin does not determine endoscopy need.

Reference: NICE Clinical Guideline 141 (Acute Upper Gastrointestinal Bleeding, 2016) & ESGE Guideline on Endoscopic Diagnosis and Management of Nonvariceal UGIH (2021). https://www.nice.org.uk/guidance/cg141/chapter/Recommendations; https://www.esge.com/assets/downloads/pdfs/guidelines/2021_a_1369_5274.pdf