THE UPPER GASTROINTESTINAL SERIES AT A CROSSROADS

Radiologic examination of the upper gastrointestinal tract, or the upp er gastrointestinal series, is at a crossroads. As we approach the 21s t century, it is possible to envision two very different scenarios for the future of this examination. The gradual but steady decline in the number of upper gastrointestinal studies done during the past decade could continue or even accelerate until this technique is no longer us ed in diagnostic radiology. Or, spurred by new concerns about cost and safety In a rapidly changing political and economic environment, the upper gastrointestinal series could undergo a dramatic resurgence, sup planting endoscopy as the primary diagnostic test in patients with sym ptoms in the upper gastrointestinal tract. Radiologists may ultimately have a pivotal role in determining the fate of the upper gastrointest inal series by their commitment or lack of commitment to perpetuating this form of examination. In this article, we consider the status of t he upper gastrointestinal series in current medical practice and the c hallenges we face if it is to remain a useful diagnostic technique in the 21st century.