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UGIB Endoscopy Timing — RACP Adult Medicine MCQ

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EasyGastroenterologyUGIB Endoscopy TimingRACP Adult Medicine

A 50-year-old man presents with haematemesis and melaena. Glasgow-Blatchford Score is 12 (high risk). HR 110 bpm, BP 95/60 mmHg. He is resuscitated with IV fluids and 2 units PRBC. Hb is now 85 g/L. He is haemodynamically stable. What is the most appropriate timing for upper GI endoscopy?

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Correct answer: C — Within 24 hours

High-risk UGIB (GBS ≥6) should undergo upper GI endoscopy within 24 hours of presentation per BSG/NICE/GESA guidelines. Earlier endoscopy (<12 hours) does not improve mortality in most patients (TRIGGER, REVISE trials). Very early endoscopy (<6 hours) may be considered for suspected variceal bleeding or haemodynamic instability despite resuscitation. GBS 0-1 can be discharged for outpatient endoscopy.

Reference: GESA – 2024 – Upper GI Bleeding; BSG 2024; NICE 2024