Endoscopic ultrasonography in the diagnosis and management of suspected upper gastrointestinal submucosal tumours

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Abstract
Background: ‘Submucosal’ lesions in the upper gastrointestinal tract are often difficult to evaluate. Endoscopic ultrasonography (EUS) provides high-quality information about the nature of these lesions and may assist management. This study assessed the use of EUS in the evaluation and management of upper gastrointestinal submucosal tumours.Methods: Forty-four consecutive patients were referred with suspected upper gastrointestinal submucosal lesions for EUS. All examinations were performed by one of two experienced endosonographers.Results: Most patients were referred for EUS with a suspected gastrointestinal stromal tumour. The pre-EUS diagnosis did not correlate with the EUS diagnosis in 25 of 44 patients. Pathological correlation was possible in 16 patients, and the EUS diagnosis was confirmed in each case. Based on the findings at EUS, 12 patients underwent resection. Pathology confirmed the ultrasonographic findings in these patients. Follow-up EUS to monitor lesions was recommended in a further three patients.Conclusion: EUS is safe and provides useful information in many patients with suspected submucosal tumours. EUS may reveal unsuspected findings and can increase physician certainty, allowing accurate diagnosis and facilitation of the management process.