Conventional single contrast barium meal versus endoscopy in diagnosis of duodenal ulcer [a comparative study of 174 cases]

A comparative study of dyspeptic patients with conventional single contrast barium meals [SCBM] and upper gastrointestinal tract [G.I.T] endoscopy for diagnosis of active duodenal ulceration[DU] is presented. 174 cases were included in this study and were divided into three groups according to their radiological findings. Group I: 56 [32.1%] patients had radiologically demonstrated ulcer niches of the duodenal cap and postbulbar area while only 22 [39.7%] patients proved to have active DU endoscopically and thus illustrating 34 [60.3%] patients with false positive ulcer niches. Group II:88 [50.6%] patients had non specific radiological signs of DU and only 21 [28.8%] proved to have active DU endoscopically. Group III: 30[17.3%] patients had X- ray negative dyspepsia and only 6 [20%] of them proved to have active DU endoscopically and this comprises the rate of false negative results for active DU in our SCBM. The endoscopic findings of each radiological group were studied and the reasons for false positive and negative results in our SCBM were discussed. Use of intravenous antispasmodic or glucagon prior to barium meals suggested and double contrast barium meals [DCBM] are seriously needed to replace our SCBM to reduce the rates of false positive and negative results in diagnosis of active DU. The endoscopic results of the patients were studied