Document Detail

Diagnostic failures in endoscopy for acute upper gastrointestinal haemorrhage.
MedLine Citation:
PMID:  10792319     Owner:  NLM     Status:  MEDLINE    
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).
Y F Chung; W K Wong; K C Soo
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The British journal of surgery     Volume:  87     ISSN:  0007-1323     ISO Abbreviation:  Br J Surg     Publication Date:  2000 May 
Date Detail:
Created Date:  2000-07-06     Completed Date:  2000-07-06     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  0372553     Medline TA:  Br J Surg     Country:  ENGLAND    
Other Details:
Languages:  eng     Pagination:  614-7     Citation Subset:  AIM; IM    
Department of Surgery, Singapore General Hospital, Outram Road, Singapore 169608.
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MeSH Terms
Diagnostic Errors
Duodenal Ulcer / diagnosis
Endoscopy, Gastrointestinal / standards*
Gastrointestinal Hemorrhage / diagnosis*,  etiology
Peptic Ulcer Hemorrhage / diagnosis
Retrospective Studies

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