Publication

Abdominal symptoms: Do they predict gallstones? A systematic review

Berger, MY., van der Velden, JJIM., Lijmer, JG., de Kort, H., Prins, A. & Bohnen, AM., Jan-2000, In : SCANDINAVIAN JOURNAL OF GASTROENTEROLOGY. 35, 1, p. 70-76 7 p.

Research output: Contribution to journalArticleAcademicpeer-review

  • MY Berger
  • JJIM van der Velden
  • JG Lijmer
  • H de Kort
  • A Prins
  • AM Bohnen

Background: Our objective was to evaluate the diagnostic accuracy of abdominal symptoms in gallstones in studies using ultrasonography or oral cholecystography as the reference standard and to assess the extent to which variability in diagnostic accuracy is explained by patient selection nd other characteristics of study design.

Methods: A Medline search (1966-1998) was conducted in combination with reference checking for further relevant publications. Two independent assessors selected controlled studies that included patients greater than or equal to 18 years of age. Articles were excluded if sensitivity and specificity could not be extracted or the included patients were at extraordinary risk for gallstones. Seven abdominal symptoms were evaluated. Modification of the diagnostic accuracy by clinical setting, extent of the disease, blinding, age, and sex was analysed by using logistic regression.

Results: A total of 24 publications were included. The symptoms 'biliary colic', 'radiating pain', and 'analgesics used' were consistently related to gallstones. The setting of the study had a significant effect on the diagnostic accuracy of these symptoms. The unadjusted pooled diagnostic odds ratios, however, were low (2.6 (95% confidence interval, 2.4-2.9), 2.8 (2.2-3.7), and 2 (1.6-2.5), respectively). The diagnostic odds ratio of biliary colic increased with the extent of gallstone disease (13.3 (4.2-42).

Conclusions: Although biliary colic was specific for gallstones, 80% of the referred patients with gallstones presented with other abdominal symptoms. There is no current evidence that justifies the use of single abdominal symptoms, other than biliary colic, in the diagnosis of symptomatic gallstones. Further research should focus on the prognosis of patients with non-specific abdominal symptoms and gallstones.

Original languageEnglish
Pages (from-to)70-76
Number of pages7
JournalSCANDINAVIAN JOURNAL OF GASTROENTEROLOGY
Volume35
Issue number1
Publication statusPublished - Jan-2000
Externally publishedYes

    Keywords

  • abdominal symptoms, cholelithiasis, diagnosis, meta-analysis, review, DIAGNOSTIC-TESTS, FOOD INTOLERANCE, DISEASE, POPULATION, PREVALENCE, PAIN, CHOLECYSTECTOMY, ULTRASOUND, REFERRALS, DYSPEPSIA

View graph of relations

ID: 15132088