The frequency of peptic ulcer as a cause of upper-GI bleeding is exaggerated.

Background: Peptic ulcer disease is considered the cause of upper-GI bleeding in 50% of cases. A recent decline in the proportion of cases of upper-GI bleeding because of a peptic ulcer was noted by us. The objectives of this study were to evaluate the frequency of peptic ulcer in patients with upper-GI bleeding and the proportion of bleeding peptic ulcers with a non-bleeding visible vessel.

Endoscopic dilation of esophageal stricture without fluoroscopy is safe and effective.

Aim: Endoscopic dilation of esophageal strictures is a commonly performed procedure in the management of dysphagia. The procedure is usually done with fluoroscopic guidance. The aim of this study was to assess the use of Tracer guide wire in conjunction with Savary-Gilliard dilators in the dilation of tight esophageal strictures without fluoroscopy.

Endoscopic removal of large colonic lipomas.

Background: Colonic lipomas are benign adipose tumors that rarely cause symptoms. Removal of lipomas 2 cm or greater in diameter has been associated with a greater risk of perforation. Experience with the evaluation and removal of large colonic lipomas with the assistance of EUS to reduce the risk of perforation is reported.

Video-endoscopic ultrasonography in staging gastric carcinoma.

Background/aims: Clinical staging of gastric carcinoma is important in designing the strategy of treatment. Early gastric carcinomas can be treated by minimally invasive therapy, whereas advanced gastric carcinomas should be treated by surgery with or without combined chemotherapy. This study was undertaken to evaluate the accuracy and limitations of video type endoscopic ultrasound in preoperative staging of gastric cancer and assessing lymph node metastasis.

Endoscopic ultrasonography in patients with gastrinomas.

Placing the endoscopic ultrasound transducer in the descending duodenum, the duodenal bulb and the stomach, all the pancreas can be imaged. Endoscopic ultrasonography is a sophisticated imaging technique able to accurately diagnose and localize primary endocrine tumours of the pancreas (mostly insulinoma and gastrinoma) which may not be detectable with other imaging modalities. Furthermore, endoscopic ultrasonography-guided fine needle aspiration allows cytology and/or biopsy specimens to be obtained, that are crucial for clinicians in decision making.

Mucosal iodine staining improves endoscopic visualization of squamous dysplasia and squamous cell carcinoma of the esophagus in Linxian, China.

Background: In previous studies in the high risk population of Linxian, China, the majority of foci of high grade (moderate and severe) squamous dysplasia (HGD) and invasive squamous carcinoma (CA) of the esophagus were associated with endoscopically visible lesions that could be targeted for biopsy, but some foci of HGD were missed by routine endoscopic examination. This study examined whether spraying the mucosa with Lugol's iodine solution, which stains normal epithelium brown but leaves dysplasia and carcinoma unstained, could improve endoscopic detection and delineation of these lesions.

Methods: Two hundred twenty-five Linxian adults with balloon cytologic evidence of dysplasia or carcinoma underwent endoscopy.

Endosonographic differentiation of benign and malignant stromal cell tumors.

Background: Endosonography (EUS) is a valuable technique for diagnosing gastrointestinal stromal cell tumors. However, EUS features that are predictive of malignancy in these tumors have not been defined.

Methods: Videotapes and photographs of EUS examinations performed prior to surgical resection of 35 stromal cell tumors (9 malignant) were blindly reviewed by a single examiner.

A new system for defining endoscopic complications emphasizing the measure of importance.

Background: Currently, there are no satisfactory systems for defining, classifying, and/or scoring endoscopic complications, although it would be important for quality assurance, comparative studies, and outcomes research. Recently the term "negative outcomes" was proposed rather than "complications," and an approach that incorporates "measures of importance" was added to compare negative outcomes.

Methods: A system was developed that defines, classifies, and grades negative outcomes with a scoring system based on measures of importance.

Staging of ampullary and pancreatic carcinoma: comparison between endosonography and surgery.

Background: The aim of the study was to update our previously published data on the clinical TNM staging of ampullary and pancreatic carcinoma by endosonography.

Methods: Endosonography was performed in 70 patients with pancreatic cancer and in 32 patients with ampullary carcinoma. TNM staging was carried out before surgery and compared with findings of histology and/or surgery.

[Mini-probe ultrasound of the upper gastrointestinal tract--1995 state of the art and perspectives. Workshop on Mini-Probe Ultrasound in Gastroenterology, Münster, 28 October 1995].

Endoscopic ultrasound (EUS) allows for intraluminal sonographic imaging of the oesophagus, stomach, pancreatobiliary duct system, the papilla of Vater, as well as the colon and rectum. EUS has proved valuable for diagnosis and staging of tumours of the upper intestinal tract. EUS can also provide valuable additional information concerning lesions that cannot be immediately classified.

The TNM staging system.

The new TNM staging system for cancer has great importance because of its applicability for imaging techniques, particularly clinical staging by EUS. The close correlation between clinical (EUS) and pathologic staging permits clinicians to define the strategy for treatment based on the stage of the cancer. In cases where lymph node metastasis is suspected, EUS-guided FNA can be performed for confirmation of this diagnosis by cytology.

Prognosis of esophageal cancers preoperatively staged to be locally invasive (T4) by endoscopic ultrasound (EUS): a multicenter retrospective cohort study.

Background: Endosonography is a significant advance in the preoperative staging (TNM classification) of esophageal cancer. Its accuracy for evaluating depth of tumor invasion is over 80%.

Methods: A multicenter retrospective cohort study of patients with esophageal carcinomas defined to be invasive (T4) by endosonography was performed to compare the survival of surgically and nonsurgically treated patients.

Proximal bile duct tumors.

This article describes the present and future clinical applications of endoscopic ultrasound (EUS) in the evaluation of Klatskin tumors. Topics discussed include instruments, investigation techniques, EUS interpretation, fine needle aspiration cytology, and color Doppler ultrasonography.

Endosonography of gastroesophageal varices: evaluation and follow-up of 76 cases.

Endosonography was performed in 76 patients who had endoscopically detected gastroesophageal varices or questionable submucosal lesions, or who were being evaluated for pancreatic carcinoma or pancreatitis. The result were compared with surgery or autopsy results. The patients were divided retrospectively into four groups.

Large gastric folds evaluated by endoscopic ultrasonography.

Diffuse large gastric folds may lead to difficult clinical diagnosis particularly in biopsy-negative cases. In the differential diagnosis Menetrier's disease or hypertrophic gastritis and linitis, EUS is very helpful because of its ability in imaging the location of mural abnormality. In initially negative biopsy for linitis, EUS can help the clinician in selecting the optimal site for positive biopsy.

Endoscopic ultrasonography of perianorectal fistulas and abscesses.

In this article we describe the history, instrument, indications, and results of endoscopic ultrasonography (EUS) in the evaluation of perianorectal fistulas and abscesses. EUS has been reported to be helpful in the management of patients with Crohn's disease or colitis associated with fistulas and abscesses, due to its clear imaging of the leasion and valuable topographic anatomical information. Recent studies point out the relationship between EUS and electromyography.

Endoscopic ultrasonography of perigastrointestinal lymph nodes.

The introduction of endoscopic ultrasonography (EUS) has opened a window in the diagnosis of the perigastrointestinal lymph nodes. Initial euphoria has been sobered by the fact that false-positive and false-negative diagnoses may occur. We review here the use of EUS to stage gastrointestinal cancer, and particularly to predict the presence or absence of lymph-node metastases.

Assessment of tumor infiltration depth in rectal cancer with transrectal sonography: caution is necessary.

Purpose: To assess the depth of infiltration of rectal cancer with transrectal ultrasound (US) (TRUS) and analyze interpretation errors.

Materials And Methods: Fifty-five consecutive patients with rectal cancer who underwent TRUS were prospectively studied. The effect of different patient inclusion criteria and US criteria was evaluated retrospectively.