[Errors in the diagnosis of peptic ulcer]

The diagnosis made at the polyclinics and at the gastroenterology clinic were studied and compared. There were 2515 patients admitted to or discharged from hospital with a diagnosis of peptic ulcer. In gastric ulcer (630 patients), the erroneous diagnoses accounted for 24.8 +/- 1.1% including 7.7 +/- 0.7% of cases undiagnosed at the polyclinics and 17.0 +/- 1.0% of cases with an overdiagnosis. In duodenal ulcer, the respective figures were 15.1 +/- 0.6, 5.7 +/- 0.4 and 9.3 +/- 0.5%. The level of gastric ulcer diagnosis was lower than that of duodenal ulcer (p less than 0.01), the rate of overdiagnoses in both cases was, respectively 2.2- and 1.6-fold higher than that of underdiagnoses. The erroneous diagnoses mostly fall within faulty ulcer localization, chronic gastritis, chronic duodenitis, and chronic biliary diseases. Three groups of factors were distinguished among the causes of errors in the diagnosis of peptic ulcer: underestimation by the physicians of the pathomorphism and changed symptomatology; erroneous assessment of the disease history and examination data; not taking into sufficient account of the disease course determined by the sex, age and polymorbidity of the today's patient. The causes of errors were not infrequently found to go together.