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  • Title: A negative double-contrast barium meal--qualified reassurance.
    Author: Arfeen S, Salter RH, Girdwood TG.
    Journal: Clin Radiol; 1987 Jan; 38(1):49-50. PubMed ID: 3816067.
    Abstract:
    Four hundred and forty-one consecutive patients referred for endoscopy after a negative double-contrast barium meal were studied to determine the reliability of good quality radiology in excluding significant upper gastrointestinal pathology. Endoscopic abnormalities were detected in 23 patients (5.2%), nine of which were reporting errors. Duodenal ulcer was the commonest lesion missed radiologically, 50% of these patients either having a history of overt upper gastrointestinal bleeding, a family history or impressive symptomatic relief with H2-receptor antagonists. The three patients with radiologically undetected gastric cancer presented with classical symptoms; the radiological demonstration of gastric mucosal atrophy in this clinical context should alert the referring clinician to initiate urgent endoscopy.
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