Abstract
To determine the current indications and referral patterns for routine gastrointestinal radiology examinations, 1000 consecutive patients were prospectively analyzed. The following specialties were the largest sources of referral: general internal medicine (38%), gastroenterology (21%), and general and colorectal surgery (17%). Referrals from gastroenterologists were weighted toward areas not well evaluated by endoscopy, such as suspected small bowel disease. The major indications for upper gastrointestinal (GI) examinations were dysphagia and swallowing disorders (32%), hiatus hernia/reflux (14%), and ulcer (14%). Small bowel series were predominantly performed for inflammatory bowel disease (37%), obstruction (25%), and occult blood loss (18%). The majority of combined upper GI/small bowel studies were performed for indications primarily relating to the small bowel. Forty percent of barium enemas were performed for detection of neoplasms and polyps, with pain/irritable colon (14%) and exclusion of leak (14%) the next most common indications. Traditional indications, such as peptic ulcer disease and neoplastic disease, continue to be sources of referral for gastrointestinal radiology. However, more specialized applications, particularly in areas not well suited to endoscopy, such as swallowing disorders, inflammatory disease of the small bowel, and evaluation of surgical anastomoses, are also being commonly used. The changing indications, along with the previously documented decreased volume of gastrointestinal radiologic procedures, should be kept in mind when planning a radiology resident educational curriculum.
Similar content being viewed by others
References
Gelfand DW, Ott DJ, Chen YM. Decreasing numbers of gastrointestinal studies: report of data from 69 radiologic practices. AJR 1987;148:1133–1136
Goodson JD, Lehmann JW, Colditz GA, et al. The diagnostic value of upper gastrointestinal radiography. J Clin Gastroenterol 1990;12:140–144
Chen MYM, Ott DJ, Kelley TF, Gelfand KW. Impact of the small bowel study on patient management. Gastrointest Radiol 1991;16:189–192
Diner WC, Hoskins EOL, Navab F. Radiologic examination of the small intestine: review of 402 cases and discussion of indications and methods. South Med J 1984;77:68–75
Maglinte DDT, Lappas JC, Kelvin FM, et al. Small bowel radiography: how, when, and why? Radiology 1987;163:297–305
Fried AM, Poulos A, Hatfield DR. The effectiveness of the incidental small-bowel series. Radiology 1981;140:45–46
Rex DK, Lappas JC, Maglinte DDT, Kelvin FM. Barium enema utilization within a defined geographic region: a survey. Gastrointest Radiol 1990;15:265–267
Vellacott KD, Virjee J. Audit on the use of the barium enema. Gut 1986;27:182–185
Margulis AR, Thoeni RF. The present status of the radiologic examination of the colon. Radiology 1988;167:1–5
Thoeni RF, Margulis AR. The state of radiographic technique in the examination of the colon: a survey in 1987. Radiology 1988;167:7–12
Gelfand DW. Gastrointestinal radiology: a short history and predictions for the future. AJR 1988; 150:727–730
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Einstein, D.M., Lieberman, J.M., Paushter, D.M. et al. Gastrointestinal radiology: Current indications and referral patterns. Abdom Imaging 18, 2–6 (1993). https://doi.org/10.1007/BF00201689
Received:
Accepted:
Issue Date:
DOI: https://doi.org/10.1007/BF00201689