Evaluation of Transabdominal Ultrasound with Oral Cellulose-Based Contrast Agent in the Detection and Surveillance of Gastric Ulcer

Abstract

The aim of this study was to assess the role of transabdominal ultrasound with cellulose-based oral contrast agent (TUS-OCCA) in the detection and surveillance of gastric ulcer. The study was approved by the institutional review board at Shengjing Hospital of China Medical University. A total of 124 consecutive patients with benign gastric ulcer diagnosed by gastroscopy and biopsy were enrolled. Serial TUS-OCCA (approximately 1 exam every 2 wk) was performed to monitor the effects of treatment, and additional interventions were planned according to the results. TUS-OCCA detected gastric ulcer in 76% of patients (94 of 124). The detection rates for lesions of ≤5 mm, lesions of 5-10 mm, lesions of 10-15 mm and lesions >15 mm were 32% (10 of 31), 77% (27 of 35), 96% (25 of 26) and 100% (32 of 32), respectively. The detection rates for lesions located in the antrum, angle and body were 70%, 84% and 85%, respectively. Among 30 undetected lesions, which ranged 2-13 mm in size, 11 were at the antrum, 9 at the angle, 3 in the body, 6 at the cardia and 1 at the fundus. During the follow-up period, patients underwent a mean of 3.8 TUS-OCCA examinations (range 2-7), and ulcers were healed after 8 wk (range 2-12 wk) of standard therapy in 76 patients. Eighteen patients who did not show improvement after standard therapy underwent repeat gastroscopy with biopsy. Repeat biopsy was positive for gastric cancer in 4 of these: 2 of the remaining 14 were diagnosed with gastric cancer at gastrectomy, and 12 were diagnosed with chronic benign ulcer. These results indicate that serial TUS-OCCA can be used for close monitoring during routine treatment of gastric ulcers that are detectable by TUS-OCCA and that monitoring by TUS-OCCA can guide additional interventions. A non-invasive follow-up program based on TUS-OCCA can also help to detect gastric cancers that have been misdiagnosed as benign ulcers at the initial endoscopic biopsy.

Evaluation of ultrasound-guided Freka-Trelumina enteral nutrition tube placement in the treatment of acute pancreatitis

“…With improvements in ultrasound techniques, transabdominal ultrasound has been used in the initial screening of gastric diseases for patients unwilling to undergo gastroscopy [18][19][20][21][22][23][24]. In the fasting state, the pylorus of most patients can be detected beneath the gallbladder neck by transabdominal ultrasound, which makes it possible to insert a feeding tube through the pylorus into the duodenum under the guidance of transabdominal ultrasound.…”

Evaluation of ultrasound-guided Freka-Trelumina enteral nutrition tube placement in the treatment of acute pancreatitis

“…With improvements in ultrasound techniques, transabdominal ultrasound has been used in initial screening of gastric diseases for patients unwilling to undergo gastroscopy [18][19][20][21][22][23][24]. In the fasting state, the pylorus of most patients can be detected beneath the gallbladder neck by transabdominal ultrasound, which makes it possible to insert a feeding tube through the pylorus into the duodenum under the guidance of transabdominal ultrasound.…”

Evaluation of ultrasound-guided Freka-Trelumina enteral nutrition tube placement in the treatment of acute pancreatitis

“…With improvements in ultrasound techniques, transabdominal ultrasound has been used in the initial screening of gastric diseases for patients unwilling to undergo gastroscopy [18][19][20][21][22][23][24]. In the fasting state, the pylorus of most patients can be detected beneath the gallbladder neck by transabdominal ultrasound, which makes it possible to insert a feeding tube through the pylorus into the duodenum under the guidance of transabdominal ultrasound.…”