Upper gastrointestinal bleeding differential diagnosis
|
Upper gastrointestinal bleeding Microchapters |
|
Differentiating Upper Gastrointestinal Bleeding from other Diseases |
|---|
|
Diagnosis |
|
Treatment |
|
Management |
|
Surgery |
|
Case Studies |
|
Upper gastrointestinal bleeding differential diagnosis On the Web |
|
American Roentgen Ray Society Images of Upper gastrointestinal bleeding differential diagnosis |
|
FDA on Upper gastrointestinal bleeding differential diagnosis |
|
CDC on Upper gastrointestinal bleeding differential diagnosis |
|
Upper gastrointestinal bleeding differential diagnosis in the news |
|
Blogs on Upper gastrointestinal bleeding differential diagnosis |
|
Directions to Hospitals Treating Upper gastrointestinal bleeding |
|
Risk calculators and risk factors for Upper gastrointestinal bleeding differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]
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[2]. Cuellar found the following results:
| Finding | Sensitivity | Specificity | Positive predictive value (prevalence of 39%) |
Negative predictive value (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[4]. Holman found that by 120 seconds after the developer was applied, the Hemoccult test was positive on all control samples.