Diagnosis of Helicobacter pylori infection in patients with bleeding ulcer disease: rapid urease test and histology.
Introduction: the endoscopic diagnosis of Helicobacter pylori infection in patients with bleeding peptic ulcer is limited by a de-creased sensitivity in standard invasive tests, rapid urease test and zistology. There is controversy about the convenience of using one, neither, or both diagnostic test...
| Publicado en: | Spanish Journal of Gastroenterology / Revista Española de Enfermedades Digestivas Vol. 96; no. 6; pp. 395 - 402 |
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| Autores principales: | , , , , |
| Formato: | research tables/charts Journal Article |
| Publicado: |
Aran Ediciones S.A.
2004 Jun
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| Acceso en línea: | Ver este registro en EBSCOhost |
| fields | @attributes: recordID: 1 pdfLink: plink: https://search.ebscohost.com/login.aspx?direct=true&db=ccm&AN=106486957&site=ehost-live header: @attributes: shortDbName: ccm uiTerm: 106486957 longDbName: CINAHL Complete uiTag: AN controlInfo: bkinfo: dissinfo: jinfo: jid: 11300108 YU3 jtl: Spanish Journal of Gastroenterology / Revista Española de Enfermedades Digestivas issn: 11300108 maglogo: N pubinfo: dt: 2004 Jun vid: 96 iid: 6 pid: 20394 pub: Aran Ediciones S.A. artinfo: ui: 106486957 106486957 2005108453 NLM15230669 106486957 ppf: 395 ppct: 7 formats: tig: atl: Diagnosis of Helicobacter pylori infection in patients with bleeding ulcer disease: rapid urease test and histology. aug: au: Castro-Fernández M Sánchez-Muñoz D Garcia-Díaz E Miralles-Sanchiz J Vargas-Romero J affil: Services of Digestive Diseases, Valme University Hospital, Seville, Spain sug: subj: Helicobacter Infections Diagnosis Helicobacter Infections Microbiology Urease Diagnostic Use Gastrointestinal Hemorrhage Diagnosis Breath Tests Methods Helicobacter Infections Drug Therapy Chi Square Test Fisher's Exact Test McNemar's Test Adult Middle Age Aged Aged, 80 and Over Female Male Human Adult: 19-44 years Middle Aged: 45-64 years Aged: 65+ years Aged, 80 & over Female Male ab: Introduction: the endoscopic diagnosis of Helicobacter pylori infection in patients with bleeding peptic ulcer is limited by a de-creased sensitivity in standard invasive tests, rapid urease test and zistology. There is controversy about the convenience of using one, neither, or both diagnostic tests.Aims: to evaluate the results of simultaneously performed rapid urease test and histology in the diagnosis of Helicobacter pylori infection (H. pylori) in patients with bleeding peptic ulcer.Patients and methods: we included 173 patients, 98 male and 75 female, with an average age of 62 years (18-88), with up-per gastrointestinal bleeding secondary to duodenal ulcer (115) or gastric ulcer (58), diagnosed within 24 hours after hospital admission. None of the patients had received treatment for H. pylori, proton pump inhibitors or antibiotics in the two weeks prior to the upper gastrointestinal bleeding episode. H. pylori infection was investigated in all patients by two antral biopsy samples for histological study (hematoxilin-eosin) and one or two antral biopsies for rapid urease test (Jatrox[R]-H.p.-test). In cases with a negative urease test and histology, a [[1][3]]C urea breath test was performed. Infection was considered present when at least one invasive test or the breath test was positive, whereas both invasive tests and the breath test had to be negative to establish an absent infection.Results: 152 patients (88%) showed H. pylori infection, 104 patients (90%) with duodenal ulcer and 48 patients (83%) with gastric ulcer. In all 119 cases (78%) were diagnosed by the urease test and 112 cases (74%) by histology. Both methods were used to diagnose 134 of 152 cases (88%) (p < 0.05), these being positive in 97 cases and negative in 39 cases. In 18 of these 39 cases, the breath test was positive.Conclusions: histology and urease test have similar diagnostic values for the identification of H. pylori in patients with bleeding pep-tic ulcer. Due to its rapid results, the urease test should be the method of choice. However, additional biopsies should be performed, and, when negative, a histological study should be carried out, since a combination of both methods allows a more precise diagnosis. pubtype: Periodical doctype: research tables/charts Journal Article ougenre: Article language: English refInfo: holdings: @attributes: islocal: N |
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