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Comparative Study
Evaluation of nasogastric tubes to enable differentiation between upper and lower gastrointestinal bleeding in unselected patients with melena.
- Boris Kessel, Oded Olsha, Aurwa Younis, Yaakov Daskal, Emil Granovsky, and Ricardo Alfici.
- aTrauma Unit, Surgical Division, Hillel Yaffe Medical Center, Affiliated to Rappoport Medical School, Technion, Hadera bDepartment of Surgery, Shaare Zedek Medical Center, Jerusalem, Israel.
- Eur J Emerg Med. 2016 Feb 1; 23 (1): 71-3.
AbstractGastrointestinal (GI) bleeding is a common surgical problem. The aim of this study was to evaluate how insertion of the nasogastric tube may enable differentiation between upper and lower GI bleeding in patients with melena. A retrospective study involving patients admitted to our surgery division with a melena was carried out between the years 2010 and 2012. A total of 386 patients were included in the study. Of these, 279 (72.2%) patients had negative nasogastric aspirate. The sensitivity of examination of nasogastric aspirate to establish the upper GI as the source of bleeding was only 28% and the negative predictive value of a negative nasogastric aspirate was less than 1%. Most patients who initially presented with melena and were found to have upper GI bleeding had a negative nasogastric aspirate. Insertion of a nasogastric tube does not affect the clinical decision to perform upper endoscopy and should not be routinely carried out.
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