Department of Gastroenterology, Turkiye Yuksek Ihtisas Teaching and Research Hospital, Ankara, Turkey.
Eur J Gastroenterol Hepatol. 2011 Jul;23(7):586-92. doi: 10.1097/MEG.0b013e3283461045.
The aim of this study was to evaluate the endosonographic ultrasound (EUS) findings of patients with suspected extraluminal compression or subepithelial intramural lesions observed during upper gastrointestinal endoscopy.
EUS findings were grouped as follows; compression by an extramural pathologic lesion, compression by an adjacent vascular structure, compression by adjacent organs, subepithelial intramural lesion, and normal EUS.
The data of 211 patients referred to the EUS unit between February 2004 and January 2010 for further evaluation of suspected extraluminal compression or subepithelial intramural lesions after upper gastrointestinal endoscopy were retrospectively analyzed. Mean age of the patients was 51.0±15.2 years, 124 (58.9%) of which were female. EUS examination was normal in 48 (22.7%) patients. EUS confirmed the presence of a pathological finding in the esophagus in 38 (92.6%) out of 41 patients when compared with abnormal findings in 122 (73.4%) of 166 patients who were evaluated for suspected lesions of the stomach (P=0.009). Suspected extraluminal compression of the esophagus (n=41) was due to a vascular structure in 17 (41.4% ) patients, an adjacent organ in four (9.7%) patients, an extramural pathological lesion in two (4.9%) patients, and a subepithelial intramural lesions in 15 (36.6%) patients, whereas in three patients (7.4%) EUS findings were normal. Of the 166 patients referred for evaluation of gastric lesions EUS findings were normal in 44 (26.5%) patients, whereas compression due to an adjacent organ was observed in 66 (39.7%) patients followed by compression by an adjacent vascular structure in 34 (20.4%) patients. An extramural pathologic lesion was discovered in 14 (8.6%) patients, whereas suspected compression was due to a subepithelial intramural lesion in eight (4.8%) patients.
Accurate diagnosis of suspected extraluminal compression or subepithelial intramural lesions, particularly in the stomach, requires meticulous evaluation. EUS provides an invasive but effective option. In one-third of cases, suspected extraluminal compression of the esophagus is actually due to a subepithelial intramural lesion.
本研究旨在评估在上消化道内镜检查中观察到的疑似腔外压迫或黏膜下壁内病变患者的内镜超声（EUS）表现。
将 EUS 表现分为以下几类：腔外病变压迫、相邻血管结构压迫、相邻器官压迫、黏膜下壁内病变和正常 EUS。
回顾性分析 2004 年 2 月至 2010 年 1 月期间因上消化道内镜检查疑似腔外压迫或黏膜下壁内病变而转至 EUS 科室进一步评估的 211 例患者的数据。患者平均年龄为 51.0±15.2 岁，其中 124 例（58.9%）为女性。48 例（22.7%）EUS 检查正常。与 166 例疑似胃部病变患者中 122 例（73.4%）的异常结果相比，EUS 在 41 例食管疑似病变患者中确认存在病理发现，占 92.6%（P=0.009）。食管疑似腔外压迫（n=41）的原因分别为血管结构 17 例（41.4%）、相邻器官 4 例（9.7%）、腔外病变 2 例（4.9%）和黏膜下壁内病变 15 例（36.6%），而 3 例（7.4%）EUS 结果正常。在 166 例因胃部病变就诊的患者中，44 例（26.5%）EUS 检查正常，66 例（39.7%）因相邻器官压迫，34 例（20.4%）因相邻血管结构压迫。14 例（8.6%）发现腔外病变，8 例（4.8%）疑似压迫为黏膜下壁内病变。
准确诊断疑似腔外压迫或黏膜下壁内病变，尤其是在胃部，需要仔细评估。EUS 提供了一种侵袭性但有效的选择。在三分之一的情况下，食管疑似腔外压迫实际上是由黏膜下壁内病变引起的。
