EurekaMag.com logo
+ Site Statistics
References:
53,869,633
Abstracts:
29,686,251
+ Search Articles
+ Subscribe to Site Feeds
EurekaMag Most Shared ContentMost Shared
EurekaMag PDF Full Text ContentPDF Full Text
+ PDF Full Text
Request PDF Full TextRequest PDF Full Text
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter
Follow on LinkedInFollow on LinkedIn

+ Translate

Evaluation of post operative gastro duodenal symptoms endoscopy or upper gastro intestinal roentgenography



Evaluation of post operative gastro duodenal symptoms endoscopy or upper gastro intestinal roentgenography



Surgery (St Louis) 86(4): 578-582



New or recurrent upper gastrointestinal symptoms are likely to occur in 15% to 20% of patients who have had a previous gastroduodenal operation. Onset of such symptoms may occur days to years following operation. Upper gastrointestinal roentgenography, the traditional mode of examination of the upper gastrointestinal tract, is often unreliable in establishing a correct diagnosis in such patients. To ascertain the reliability of roentgenographic examination as opposed to fiberoptic endoscopy, the diagnostic accuracy of both modalities was compared in 142 consecutive patients who had undergone previous upper gastrointestinal operation. This comparison encompassed a 4 yr period and involved a university-affiliated teaching hospital, a Veterans Administration hospital and 5 private hospitals. These examinations were undertaken during a period from 2 wk to more than 20 yr ofllowing operation. The diagnosis as disclosed by roentgenographic examination was incorrect or incomplete in 71 patients (50%). Of the 71 patients, 30 (42%) required operations to treat conditions diagnosed endoscopically that were missed on roentgenographic examination. Furthermore, in 19 patients (27%) endoscopic examination disproved a roentgenographic diagnosis which would have led to an unnecessary operation. In 22 patients (31%) no alteration in therapy resulted from the roentgenographic diagnostic inaccuracies. No particular anatomic reconstruction examined after operation was associated with an increased or decreased likelihood of incorrect diagnosis by roentgenographic examination. Thus 35% of the patients in this series had a major revision in therapy following endoscopic examination which altered or corrected a diagnosis disclosed roentgenographically. The high rate of diagnostic inaccuracy and the potential for inappropriate treatment associated with upper gastrointestinal roentgenographic examination emphasize the necessity for upper gastrointestinal endoscopy in every patient who has had any gastroduodenal operation and presents with significant persisting upper gastrointestinal symptoms.

(PDF emailed within 1 workday: $29.90)

Accession: 005400614

Download citation: RISBibTeXText

PMID: 483167



Related references

National american society for gastro intestinal endoscopy survey on upper gastro intestinal bleeding complications of endoscopy. Digestive Diseases & Sciences 26(SUPPL 7): 55S-59S, 1981

A critical look at the accuracy of endoscopy and double contrast radiography of the upper gastro intestinal tract in patients with substantial upper gastro intestinal hemorrhage. Radiology 135(2): 305-308, 1980

Comparison of endoscopy and upper gastro intestinal series in diagnostic accuracy and therapy in acute upper gastro intestinal hemorrhage. Gastroenterology 68(4 PART 2): 1034, 1975

Upper gastro intestinal bleeding results of the american society for gastro intestinal endoscopy national survey. Gastrointestinal Endoscopy 26(2): 77-78, 1980

Gastro duodenal reflux in pathology of the upper part of the gastro intestinal tract. Sovetskaya Meditsina (10): 36-39, 1983

Fibrinolytic activity of gastro duodenal secretions a possible role in upper gastro intestinal hemorrhage. Thrombosis Research 17(6): 819-830, 1980

Management of gastro-oesophageal reflux disease: role of proton pump inhibitor test and upper gastro-intestinal endoscopy. Acta Otorhinolaryngologica Italica 26(5): 271-275, 2007

Prognosis of upper gastro intestinal bleeding preliminary results of the american society for gastro intestinal endoscopy national bleeding survey. Gastroenterology 76(5 PART 2): 1138, 1979

Proceedings of the international symposium of the czechoslovak society of gastro enterology and nutrition and of the seminar of the international society of gastro intestinal endoscopy on urgent endoscopy of digestive and abdominal diseases new fields of gastro intestinal endoscopy prague czechoslovakia june 3 5 1971 karlovy vary czechoslovakia june 6 1971. Maratka, Z And J Setka (Ed ) Urgent Endoscopy Of Digestive And Abdominal Diseases New Fields Of Gastrointestinal Endoscopy Proceedings Of An International Symposium, Proceedings Of A Seiminar June 3-5, 1971, Prague, Czechoslovakia; June 6, 1971, Karlovy Vary, Czechoslovakia Ix+308p Illus S Karger: Basel, Switzerland; New York, N Y , U S A 1-304, 1972

Clinical evaluation of endoscopy for the upper gastro intestinal bleeding. Maratka, Z. Setka (ed.). Urgent Endoscopy Of Digestive And Abdominal Diseases. New Fields Of Gastrointestinal Endoscopy. Proceedings Of An International Symposium, Proceedings Of A Seiminar. June 3-5, , Prague, Czechoslovakia; June 6, 1971, Karlovy Vary, Czechoslovakia. Ix 308p. Illus. S. Karger: Basel, Switzerland; New York, N.y., U.s.a. 39-43, 1972

Control of post operative nausea and vomiting a comparative study of diphenidol gastro intest vontrol gastro intest and dimenhydrinate gastro intest gravol gastro intest human. Canadian Anaesthetists' Society Journal 15(4): 369-377, 1968

Upper gastro intestinal endoscopy is unhelpful in the evaluation of hiv sero positive patients. Gastroenterology 102(4 PART 2): A20, 1992

Endoscopic balloon dilation for post operative stricture of upper gastro intestinal tract. Gastroenterological Endoscopy 26(2): 213-223, 1984

Bedside endoscopy with the pediatric endoscope in the evaluation of upper gastro intestinal complaints in adults. Gastroenterologypart 2: 1214, 1979

Continuous low flow enteral resuscitation in post operative upper gastro intestinal hemorrhage in 50 cases. Journal of Medicine (Westbury) 7(2): 123-129, 1976