Diagnosis and treatment of gastrointestinal bleeding: When, with what and by whom?: Overview

Gastrointestinal hemorrhage continues to provoke considerable interest, with particular emphasis on the role of endoscopic and radiological techniques to arrest hemorrhage, or reduce episodes of rebleeding. Gastroenterologists have explored a wide variety of pharmacological agents which suppress acid secretion and lower peptic activity, inhibit fibrinolysis, or reduce portal pressure. The interventional radiologists can selectively catheterize the major vessels of the gastrointestinal blood supply, and access the portal venous system by the percutaneous hepatic route. With accurate endoscopic and angiographic diagnosis, and better identification of risk factors, the surgeon can confidently define his operative procedure. I should like to thank all the authors for their outstanding contributions which complement each other and provide an excellent perspective for our approach to the patient with gastrointestinal bleeding. Furthermore, they highlight the important, continuing controversies that will hopefully stimulate clinical investigators to clarify these outstanding questions for us in the future.