[Comparison of endoscopy and the milk 99mTc-EHIDA test in assessing duodenogastric reflux]

Duodenogastric reflux was estimated in 101 patients with chronic gastritis by means of endoscopy and milk 99mTc-EHIDA test. 61 patients (60.4%) were deemed to be duodenogastric reflux positive by endoscopy, as compared to 40 patients (39.6%) by milk 99mTc-EHIDA test. These differences are statistically significant (P less than 0.005). The discrepancy arises largely from the error in endoscopic estimation of duodenogastric reflux. In a group of 58 patients who were mild to moderate reflux positive by endoscopy, the assessment made by the milk 99mTc-EHIDA test was reflux positive in only 33 (57%). In other words more than 40% of the endoscopically reflux positive patients did not show reflux with 99mTc activity in the stomach. Measurement of the ratio of 99mTc activity in gastric aspirates to the total 99mTc activity injected intravenously was carried out in 13 patients. A perfect correlation was found between the ratio and the grading of duodenogastric reflux estimated by the milk 99mTc-EHIDA test. This finding suggests that by using the milk 99mTc-EHIDA test, duodenogastric reflux may be monitored semiquantitatively without recourse to a nasogastric tube. Furthermore, 10 patients were evaluated twice by the milk 99mTc-EHIDA test at intervals ranging from 3-14 days. In 8 patients the results were identical. This indicates the good reproducibility of the test. This study demonstrates that milk 99mTc-EHIDA test is a more physiological and more accurate method of studying duodenal contents in the stomach, than endoscopy.