title: A negative double-contrast barium meal--qualified reassurance.
abstract: Four hundred and forty-one consecutive patients referred for endoscopy after a negative double-contrast barium meal were studied to determine the reliability of good quality radiology in excluding significant upper gastrointestinal pathology. Endoscopic abnormalities were detected in 23 patients (5.2%), nine of which were reporting errors. Duodenal ulcer was the commonest lesion missed radiologically, 50% of these patients either having a history of overt upper gastrointestinal bleeding, a family history or impressive symptomatic relief with H2-receptor antagonists. The three patients with radiologically undetected gastric cancer presented with classical symptoms; the radiological demonstration of gastric mucosal atrophy in this clinical context should alert the referring clinician to initiate urgent endoscopy.
mesh_terms: D001466:Barium Sulfate; D004064:Digestive System / Q000000981:diagnostic imaging*; D004724:Endoscopy; D005767:Gastrointestinal Diseases / Q000000981:diagnostic imaging*; D006801:Humans; D008722:Methods; D011859:Radiography
chemical_list: D001466:Barium Sulfate