Poppy seed test (medical sign)

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Not to be confused with Poppy seed test, a drug testing for illegal use or abuse of opiates.

In medicine, the poppy seed test is a diagnostic test used before surgery to predict if surgery will find a vesicointestinal fistula or colovesical fistula (an abnormal direct pathway between the colon and urinary bladder) or other type of vesicointestinal fistula.

Method[edit]

The test is very simple. The patient is fed 1.25 g of poppy seeds with 12 ounces of fluid or 6 ounces of yogurt. The patient's urine is then collected for the next 48 hours and examined for poppy seeds. If a poppy seed is found in the urine, the patient has a colovesical or related fistula.[1]

The test is very accurate. In a series of 49 patients who underwent surgery for colovesical fistula due to sigmoid diverticulitis, the poppy seed test gave a correct diagnosis more often than abdominopelvic computerized tomography, magnetic resonance tomography of the abdomen, cystogram, retrograde colonic enema, urethrocystoscopy, and colonoscopy.[2] In a series of 20 patients in the United States, the poppy seed test was significantly more accurate than computed tomography.[3] In these two series, respectively, sensitivity of the test was 94.6% and 100%. Because of the physical nature of the test, specificity of the test is necessarily 100%.

The test is very inexpensive. In the United States it has been reported to cost under 6 dollars and two orders of magnitude less than computed tomography.[3]

The test was first described in the English medical literature in 2001, by a group of urologists in Germany. From 1994 to 1999, they gave 250 grams (8.8 oz) of poppy seeds to a series of 17 patients, then examined the patients' urine for two days. The test results were correct for all patients: 11 patients with fistulas did pass poppy seeds in their urine and 6 patients without fistulas did not pass poppy seeds.[4]

References[edit]

  1. ^ Stephen W. Leslie (2009). Urology Board Review. Pearls of Wisdom (3 ed.). McGraw Hill Professional. p. 521. ISBN 0-07-160583-5. 
  2. ^ Melchior S, Cudovic D, Jones J, Thomas C, Gillitzer R, Thüroff J (September 2009). "Diagnosis and surgical management of colovesical fistulas due to sigmoid diverticulitis". The Journal of Urology 182 (3): 978–82. doi:10.1016/j.juro.2009.05.022. PMID 19616793. 
  3. ^ a b Kwon EO, Armenakas NA, Scharf SC, Panagopoulos G, Fracchia JA (April 2008). "The poppy seed test for colovesical fistula: big bang, little bucks!". The Journal of Urology 179 (4): 1425–7. doi:10.1016/j.juro.2007.11.085. PMID 18289575. 
  4. ^ Schwaibold H, Popiel C, Geist E, Hartung R (August 2001). "Oral intake of poppy seed: a reliable and simple method for diagnosing vesico-enteric fistula". The Journal of Urology 166 (2): 530–1. doi:10.1016/S0022-5347(05)65976-9. PMID 11458060.