The sensitivity of radiography of the postoperative stomach

The results of radiology and endoscopy were compared in 140 patients who had undergone gastric surgery for ulcer disease. Of 74 patients who were examined with single-contrast radiography, 37 had abnormalities that were demonstrated endoscopically. The radiographic sensitivities in these patients were: gastritis 2/22 (9%); ulcer 3/5 (60%); obstruction 8/8 (100%); and miscellaneous abnormalities 2/2 (100%). The predictive accuracy of a diagnosis of ulcer was 38%. Of the 66 patients who were examined with double-contrast radiography, 33 abnormalities were found with endoscopy. The radiographic sensitivities were: gastritis 3/13 (23%); ulcer 7/10 (70%); obstruction 4/4 (100%); and miscellaneous abnormalities 6/6 (100%). The predictive accuracy of a diagnosis of ulcer was 44%. Radiology appears to be unreliable in diagnosing gastritis and recurrent ulceration in the postoperative stomach. The double-contrast technique does not offer significant improvement over the single-contrast method in evaluating these postoperative problems.