Values of endoscopic ultrasonography for diagnosis and treatment of duodenal protruding lesions

Abstract

Abstract:Objective: The diagnoses of patients with duodenal protruding lesions are difficult when using conventional examinations such as computed tomography (CT) and conventional endoscope etc. Thus, we investigated the clinical value of endoscopic ultrasonography (EUS) with miniature ultrasonic probes on the diagnosis and treatment of duodenal protruding lesions. Methods: Patients with duodenal protruding lesions who were indicated for EUS were examined by EUS with 12~15 MHz miniature ultrasonic probes and double-cavity electronic endoscope. According to diagnosis of EUS, those patients were indicated for biopsy and treatment received biopsy, endoscopic resection or surgical excision. The postoperative histological results were compared with the preoperative diagnosis of EUS. Those patients without endoscopic resection or surgical excision were periodically followed up with EUS. Results: A total of 169 patients with duodenal protruding lesions were examined by EUS, of which 40 were diagnosed with cysts, 36 with inflammatory protruding or polyp, 25 with Brunner's gland adenoma, 19 with ectopic pancreas, 17 with gastrointestinal stromal tumor, 12 with extrinsic compression, 12 with minor papilla, 6 with lipoma, 1 with adenocarcinoma and 1 with lymphoma. After EUS examinations, 75 patients received biopsy, endoscopic resection or surgical excision respectively. The postoperative histological results of 70 patients were completely consistent with the preoperative diagnosis of EUS, with 93.33% diagnostic accuracy. The results of follow-up with EUS indicated that duodenal cyst, Brunner's gland adenoma, ectopic pancreas, gastrointestinal stromal tumor and lipoma remained unchanged within 1~3 years. No related complications occurred among all patients that received EUS examinations. Conclusion: EUS is an effective and reliable diagnostic method for duodenal protruding lesions.

The value of endoscopic ultrasonography on diagnosis and treatment of esophageal hamartoma

“…So EUS can provide more diagnostic information about submucosal lesions, which will help to diagnose and differentiate submucosal lesions. At the present, EUS is the best means to diagnose submucosal tumors (Chen et al, 2001;Gress et al, 2001;Fusaroli and Caletti, 2005;Xu et al, 2008). Ultrasonic image of the present case showed a hypoechoic lesion, internal echos of which were uneven, with many lumen-like structures.…”

A giant Brunner’s gland hamartoma being treated as a pedunculated polyp: a case report

“…Because BGH was usually covered with normal mucosa, the value of pinch biopsies might be limited. Endoscopic ultrasound (EUS) may be helpful in the diagnosis and treatment of BGH [12]. In our case, taking into account that a complete specimen for histological examination could be obtained easily by HSP, we did not perform a EUS.…”

Pancreatic lipoma: a pancreatic incidentaloma; diagnosis with ultrasound, computed tomography and magnetic resonance imaging

“…Pancreatic lipomas are rare tumours. In 2008, Xu et al 6 reviewed 169 cases of protruding lesions in the duodenum and found only one lipoma (0.59%). In 2006, Hois et al 7 analyzed 6000 CT scans and identified pancreatic lipomas in 5 of them (0.083%).…”