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Journal of the Korean Academy of Family Medicine 1990;11(1):9-13.
Published online January 1, 1990.
1차진료에서의 상부위장관계검사의 적응증 수립을 위한 조사 (An Investigation to Establish Indications for Upper Gastrointestiaal Evaluations in Primary Care)
김창엽(Kim Chang Yeop),서홍관(Seo Hong Kwan),허봉렬(Huh Bong Yul)
서울대학교병원 가정의학과
Upper gastrointestinal symptoms and problems are very frequent and important in primary care. Upper GI evaluations have been frequently performed to discriminate undifferentiated problems and make accurate diagnoses. But these evaluations couldn't be done all the time in primary care due to many limitations, so indications should be established.
To establish indications for upper GI evaluation including gastrofiberscopy and upper GI barium study, the authors analyzed the history of epigastric hunger pain, epigastric tenderness on palpation, stool occult blood testing, and the results of endoscopic or radiological evaluations. For each of hunger pain, tenderness, stool occult blood, and combinations of hunger pain and tenderness, of hunger pain and tenderness and stool occult blood, sensitivity, specificity, positive and negative predictability were obtained.
The results were as follows;
1. Subjects of study were 36 male and 32 female patients. Average age were 38.9(male) and 36.5(female) in years.
2. Gastrofiberscopy and upper GI study were performed to 66 and 2 patients, respectively.
Of these patients, peptic ulcer was detected in 9, erosive gastritis in 6, and other gastritis in 11 patients, respectively.
3. Positive results were not significantly correlated with hunger pain, tenderness, positive stool occult blood, and combinations of these symptoms or signs in sensitivity, specificity, and predictability.
These results showed that hunger pain, epigastric tenderness, or stool occult blood would not be used as meaningful indicators for upper GI evaluation. But further investigation should be performed to establish these indicators, especially in primary care settings.
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