Abstract
In 200 consecutive upper gastrointestinal endoscopic examinations in patients having a concomitant upper gastrointestinal X-ray study, the duodenum was entered in 183. In 144 cases endoscopic and X-ray diagnosis of duodenal bulb pathology agreed; in 37, the diagnosis was made only by endoscopy; and in 19, by X-ray alone. Of 59 patients with duodenal ulcers, endoscopy diagnosed 55 and X-ray, 42. A total of 70 ulcers were identified in the 59 patients, 66 (94%) by endoscopy and 45 (65%) by X-ray. Associated duodenal deformity made X-ray interpretation difficult. Duodenitis was commonly encountered endoscopically, producing symptoms in some patients in the absence of frank ulceration. In order to determine the full extent of upper gastrointestinal pathology, esophagus, stomach, and proximal duodenum were examined with a forward-viewing endoscope in all cases. A lateral-viewing endoscope was used for supplementation in 50 cases, and furnished additional information on 18 duodenal bulbs.
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