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{{Upper gastrointestinal bleeding}}
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==Overview==
 
==Differential Diagnosis==
Determining whether blood is in gastric contents, either vomited or aspirated specimens, is surprisingly difficult. Slide tests are based on orthotolidine (Hematest reagent tablets and Bili-Labstix) or guaiac (Hemoccult and Gastroccult). Rosenthal found orthotolidine-based tests more sensitive than specific; the Hemoccult test's sensitivity reduced by the acidic environment; and the Gastroccult test be the most accurate{{ref|5}}. Cuellar found the following results:
 
{| class="wikitable" style="text-align:center"
|+ Determining whether blood is in the gastric aspirate{{ref|4}}
! Finding !! Sensitivity !! Specificity !! Positive predictive value<br>(prevalence of 39%)!! Negative predictive value<br>(prevalence of 39%)
|-
! Gastroccult
| 95% || 82% || 77% || 96%
|-
! Physician assessment
| 79% || 55% || 53% || 20%
|}
 
Holman used simulated gastric specimens and found the Hemoccult test to have significant problems with non-specificy and false-positive results, whereas the Gastroccult test was very accurate{{ref|6}}. Holman found that by 120 seconds after the developer was applied, the Hemoccult test was positive on ''all'' control samples.
 
==References==
==References==
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{{reflist|2}}


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Revision as of 17:26, 7 February 2013

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