"Skinny" upper gastrointestinal endoscopy--the initial diagnostic tool: a prospective comparison of upper gastrointestinal endoscopy and radiology.

One hundred twenty-five patients were prospectively evaluated with upper gastrointestinal "skinny" endoscopy and radiology. Seventy-five patients underwent endoscopic examination before barium studies, whereas 50 patients underwent radiologic examination before endoscopy. If superficial mucosal erosions are eliminated, the areas of greatest disagreement occurred in the postoperative stomach, the deformed antrum, and the deformed duodenal bulb. We conclude that 1) a barium meal is not a prerequisite to a complete endoscopic examination by a trained endoscopist, 2) a barium meal following an adequate endoscopic examination usually adds little new information, and 3) "skinny" endoscopic examination can be utilized as the initial and usually the only diagnostic test in most patients with upper gastrointestinal symptoms.