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- Title
Diagnostic failures in endoscopy for acute upper gastrointestinal haemorrhage.
- Authors
Chung, Y. F. A.; Wong, W. K.; Soo, K. C.
- Abstract
Summary Background: Oesophagogastroduodenoscopy (OGD) is the diagnostic tool of choice in acute upper gastrointestinal haemorrhage. However, the factors causing diagnostic failure are not well documented or discussed. Methods: OGDs performed by a single surgeon for acute upper gastrointestinal haemorrhage were reviewed retrospectively for ‘missed’ diagnosis. Results: There were nine cases (1·4 per cent) of ‘missed’ diagnosis in 638 OGDs performed over a 3-year period. Incomplete examination caused by a fundal pool precluded three examinations in which two Dieulafoy's lesions and one chronic gastric ulcer were later found. Other difficult examination sites were the cardia/high lesser curve (three cases), the stomal line of a gastrojejunostomy anastomosis (two) and at the junction of the first and second part of the duodenum (one). Four of the overlooked diagnoses were Dieulafoy's lesions. Conclusion: OGD was able to diagnose the cause of bleeding in 98·6 per cent of patients with acute upper gastrointestinal haemorrhage. The factors that caused diagnostic failure were a difficult examination site and failure to recognize lesions (Dieulafoy's).
- Subjects
GASTROINTESTINAL hemorrhage diagnosis; CLINICAL pathology
- Publication
British Journal of Surgery, 2000, Vol 87, Issue 5, p614
- ISSN
0007-1323
- Publication type
Article
- DOI
10.1046/j.1365-2168.2000.01386.x