Endosonography in the assessment of esophageal stenosis.

EUS is an invaluable tool to delineate the cause of esophageal strictures. In primary esophageal carcinoma, EUS is the most accurate means for locoregional tumor staging. The addition of EUS FNA improves lymph node staging accuracy over EUS alone. EUS FNA can also play a role in diagnosing the cause of strictures associated with lymphadenopathy or metastatic tumor. In all settings, aggressive dilation to allow passage of the echoendoscope is associated with a substantial risk of perforation and should be avoided. To overcome this problem, catheter-based and over-the-wire probes are being developed to permit EUS imaging of severe stenoses.