الفهرس 
ِAcknowledgementOnly 14 pages are availabe for public view
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Abstract
The ability of endoscopic ultrasonography (EUS) to delineate various layers of the gastrointestinal wall has made it a valuable tool for evaluation of gastrointestinal (GI) tract lesions or lesions adjacent to the GI tract. Although EUS can accurately stage GI malignancies, it cannot alone reliably differentiate benign from malignant lesions or neoplastic from inflammatory processes. Consequently, pathologic examination is often required to establish a definitive diagnosis for further clinical management. Our study was carried out to further validate the usefulness of EUS-FNA for diagnosis and staging of rectal and perirectal lesions. Our study was prospectively conducted at El-Ebrashi Unit of Gastroenterology, Hepatology and Endoscopy Unit, Internal Medicine Hospital, Cairo University Hospitals during the period from June 2017 to May 2019. Seventy patients with rectal and/or perirectal lesions detected either by an imaging modality (abdomino-pelvic CT or MRI) and /or endoscopy (sigmoidoscopy or colonoscopy) was selected. After obtaining consent, all patients were subjected to full history taking and thorough physical evolution. A detailed review of previous abdominopelvic imaging and/or endoscopy was done. A presumptive diagnosis was made according to endoscopy (colonoscopy) and imaging. EUS with elastography was done for all 70 patients and FNA was done for 26 patients where it was possible and wall thickness was sufficient for sampling. Mean age of the study population was 51.91 (9.9) years with range of age between 26 to 69 years. Out of those patients enrolled in the study, 44 (62.9%) patients were males, and 26 (37.1%) patients were females. About validity of EUS (N. 70), there was a perfect agreement (Kappa Agreement = 1) with statistical significance (P < 0.001) between EUS diagnosis and final diagnosis in the benign lesions in 32 cases (45.7%) and in the malignant lesions in 38 cases (54.3%). Sensitivity of EUS was 100%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 100% and accuracy was 100%.Concerning validity of EUS-FNA of the selected group of patients (N. 26), there was a perfect agreement (Kappa Agreement = 1) with statistical significance (P < 0.001) between EUS-FNA diagnosis and final diagnosis in the benign lesions in 5 cases (19.2%) and in the malignant lesions in 21 cases (80.8%). Sensitivity of EUS-FNA was 100%, specificity was 100%, positive predictive value (PPV) was 100%, negative predictive value (NPV) was 100% and accuracy was 100%.