Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.
Gastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. A total of 386 patients were included in the study. Of these, 279 (72.2%) patients had negative nasogastric aspirate. The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.
aTrauma Unit, Surgical Division, Hillel Yaffe Medical Center, Affiliated to Rappoport Medical School, Technion, Hadera bDepartment of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
Boris
B
Kessel
Oded
O
Olsha
Aurwa
A
Younis
Yaakov
Y
Daskal
Emil
E
Granovsky
Ricardo
R
Alfici
D000328:Adult; D000368:Aged; D015331:Cohort Studies; D003937:Diagnosis, Differential; D004636:Emergency Service, Hospital; D005260:Female; D005766:Gastrointestinal Contents; D006471:Gastrointestinal Hemorrhage / Q000175:diagnosis* / Q000453:epidemiology / Q000601:surgery; D006760:Hospitalization / Q000706:statistics & numerical data; D006801:Humans; D007441:Intubation, Gastrointestinal / Q000379:methods*; D008297:Male; D008551:Melena / Q000175:diagnosis* / Q000209:etiology; D008875:Middle Aged; D012189:Retrospective Studies; D018570:Risk Assessment; D012720:Severity of Illness Index