The diagnostic accuracy of barium studies of the stomach and duodenum--correlation with endoscopy

Radiologic and endoscopic diagnoses were compared in 240 patients. In 175 patients examined by a standard barium contrast technique there were 39 radiological errors (22%). The most common causes of error were failure to detect an abnormality on the radiograph and prominent mucosal folds which could either mask or simulate small lesions. In 65 patients examined by a formal double contrast technique using effervescent pills and a thick barium suspension, there were 4 radiological errors (6%). In addition, superficial gastric erosions were demonstrated in 7 patients. Double contrast radiography appears to offer the potential for significant improvements in diagnostic accuracy.