The role of barium meal examination in diagnosis and evaluation of diseases of the upper gastrointestinal tract at Kenyatta National Hospital

Abstract

In this prospective study over a period of six months (May-November 1997), to determine the role of Barium Examination in evaluation of upper gastro-intestinal tract (GIT) diseases at Kenyatta National Hospital, a total of 320 patients were investigated. During this period 520 patients were booked for upper GIT examination. 200 patients were not investigated because half of them never turned up while the rest were re-booked as only one fluoroscopy unit was operational. Of those who underwent the investigation 183 (57.2%) were females and 137(42.8%) were males. After double contrast upper GIT examination the results showed 100 (31.3%) patients to have normal upper GIT though they may have been sick elsewhere. Suspected peptic ulcer disease (PUD) was by far the leading clinical diagnosis prompting clinicians to request for an upper GIT barium examination. Among the 258(80.6%) patients thought to have PUD 70(27.1%) were found to be normal, 130 (50.4%) had duodenal ulcer and 36 (14.0%) had duodenitis. The next leading provisional clinical diagnosis requiring upper GIT investigation was oesophageal carcinoma with 14 (4.4%) cases followed by gastric carcinoma with 10(3.1%) cases. Patients of all age groups were examined and included in the study so long as there was no contraindication. The mean age group was 25-30 years with a total number of 99(31%) patients. Those undergoing upper GIT barium examination were questioned on their blood group. 76(23.8%) out of 320 patients could recall their blood group which was recorded down. The majority of these were blood group "0" (45/76). The low figure of those who know their blood group could be explained, among other reasons, by the fact that some patients were either too young or too old to understand blood group, or had not even been tested. It is therefore appreciated that the best way to correlate blood group and upper GIT diseases is to perform venipuncture (or finger prick) for blood grouping on every patient undergoing upper GIT barium investigation.