الفهرس 
Endoscopic UltrasoundOnly 14 pages are availabe for public view
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Abstract
Endoscopic ultrasonography (EUS) has evolved
over the past 20 years with the emergence of novel
diagnostic and therapeutic indications.
EUS has an important role in diagnosis, extent,
intraluminal and vascular invasion of upper
gastrointestinal and pancreatic lesions, in the
differential diagnosis and tumor grading (benign,
premalignant or malignant) of cystic lesions, diagnosis
and loco-regional staging of esophageal cancer,
differential diagnosis of sub epithelial lesions,
thickened gastric folds, mucosa-associated lymphoid
tissue lymphoma, diagnosis of chronic pancreatitis,
differential diagnosis of a solid mass in patients with
chronic pancreatitis, differential diagnosis of pancreatic
cyst and detection of occult pancreatic cancer.
The aim of this work is assessment of one year
activities of Endoscopic Ultrasound in diagnosis of
upper gastrointestinal and pancreatic lesions in
National Hepatology and Tropical Medicine Research
Institute.
In order to fulfill our aim, 62 patients underwent
EUS were enrolled in the study, 36 males (58%) and 26
females (41.9%).
All data in the patients’ records were collected and
analyzed statistically to assess the role of EUS in
diagnosis of different lesions in the upper GIT and the
pancreas including tumors, polyps, swellings and other
masses. The study was held in the endoscopy unit of
National Hepatology and Tropical Medicine Research
Institute.
All included patients were subjected to full history
taking and laboratory investigations as complete blood
count, total and direct bilirubin, AST, ALT, HBsAg,
HCV-Ab, Carcinoemberyonic Ag and Cancer Ag 19.9.
All patients were subjected to radiological
investigations as Abdominal Ultrasound and CT
abdomen.
According to their presenting complaint, (e.g
epigastric pain, vomiting, dysphagia, obstructive
jaundice, heamatemesis and elevated tumor markers)
and according to the site of the lesion, patients were
subjected to either an Upper GI Endoscope or an
Endoscopic Retrograde CholangioPancreatography.
All patients were subjected to an Endoscopic
Ultrasound using an electronic Pentax linear array
machine type EG3830UT adapted to a Hitachi
sonographic machine type EUB-5500.
All patients who had upper GI and pancreatic tumors
were subjected to an Endoscopic Ultrasound as a
preoperative investigation for staging.
Patients with undiagnosed esophageal, gastric,
duodenal, and pancreatic masses were subjected to
EUS-guided FNA.
The results showed that regarding the presenting
complaint of all the 62 patients, more than 48% of
the studied cases were presented by obstructive
jaundice.
The ERCP findings of 31 patients showed that
29% of the studied cases had swollen papilla, plastic
stenting was done to more than 90% of the studied
cases.
The EUS findings of all 62 studied patients showed
that GastroIntestinal Stromal cell Tumors were detected
among 16% of the studied cases, pancreatic mass
lesions were detected among 25.8% of the studied
cases.
Out of 62 patients who underwent EUS, definitive
diagnosis was obtained in 40 patients. The conclusive
diagnosis was obtained by using EUS-guided FNA
biopsy, cytology and pathology, post operative
pathological diagnosis or follow up EUS.
Out of these 40 cases, EUS showed the same diagnosis
in 37 cases that were confirmed by the previously stated
methods and missed the diagnosis of 3 cases.
In the present study, EUS was found to be more
sensitive than abdominal CT in detection of gastroesophageal,
papillary and pancreatic lesions.
In the present study, EUS was found to be more
sensitive than ERCP in the diagnosis and staging of
papillary and pancreatic mass lesions.
from this study we concluded that EUS has a
sensitivity of 96%, a specificity of 85%and an overall
accuracy of 92% for the diagnosis of upper GI and
pancreatic lesions.