Upper gastrointestinal series: patient management and a study of 199 cases

Records of 199 patients were analyzed retrospectively after upper gastrointestinal (UGI) series to assess its impact on patient management. Symptoms most predictive of an abnormal UGI series were dysphagia, UGI hemorrhage, abdominal pain, and chest pain. However, 23% of inpatients with seemingly trivial symptoms had shown abnormal results of the study. Overall sensitivity of the UGI series was 65%, which rose to 82% if esophagitis, gastritis, and abnormalities of the postoperative stomach were excluded. Effects on patient management included: serious pathologic change ruled out (53%), further studies ordered (21%), change of therapy (17%), existing therapy continued (16%), surgery performed (7%), and radiologic abnormality ignored (5%). In no case did the combination of initial screening by UGI series followed by endoscopy as indicated lead to subsequently reported morbidity or mortality due to a failure of diagnosis.