In a patient with acute upper GI bleeding, which procedure is indicated to both identify and potentially treat the issue?

In the context of acute upper gastrointestinal bleeding, esophagogastroduodenoscopy (EGD) is the most appropriate choice because it serves a dual purpose: both diagnosing the source of the bleeding and providing therapeutic interventions. EGD allows direct visualization of the upper GI tract, which includes the esophagus, stomach, and duodenum, enabling the identification of potential causes of bleeding such as ulcers, gastric varices, or malignancies.

Notably, during the EGD, various therapeutic actions can be performed, such as cauterization of bleeding vessels, clipping active bleeds, or banding of varices, which can immediately address life-threatening situations. This procedural capability makes EGD a critical component in the management of acute upper GI bleeding scenarios.

In contrast, other options like colonoscopy primarily examine the lower GI tract and would not be effective for upper GI bleeding. CT scans can provide valuable information but do not allow for direct intervention. ERCP is specifically utilized for biliary and pancreatic duct issues, which are not typically the primary concern in cases of upper GI bleeding. Thus, the unique combination of diagnostic and therapeutic benefits offered by EGD makes it the procedure of choice in this clinical scenario.