الفهرس 
Role of EUS in DiagnosisOnly 14 pages are availabe for public view
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Abstract
Endoscopic ultrasonography (EUS) has evolved over the past 20 years with the emergence of novel diagnostic and therapeutic indications.
EUS has an important role in diagnosis, extent, intraluminal and vascular invasion of upper gastrointestinal and pancreatic lesions, in the differential diagnosis and tumor grading (benign, premalignant or malignant) of cystic lesions, diagnosis and loco-regional staging of esophageal cancer, differential diagnosis of sub epithelial lesions, thickened gastric folds, mucosa-associated lymphoid tissue lymphoma, diagnosis of chronic pancreatitis, differential diagnosis of a solid mass in patients with chronic pancreatitis, differential diagnosis of pancreatic cyst and detection of occult pancreatic cancer.
The aim of this work is assessment of one year activities of Endoscopic Ultrasound in diagnosis of upper gastrointestinal and pancreatic lesions in National Hepatology and Tropical Medicine Research Institute.
In order to fulfill our aim, 62 patients underwent EUS were enrolled in the study, 36 males (58%) and 26 females (41.9%).
All data in the patients’ records were collected and analyzed statistically to assess the role of EUS in diagnosis of different lesions in the upper GIT and the pancreas including tumors, polyps, swellings and other masses. The study was held in the endoscopy unit of National Hepatology and Tropical Medicine Research Institute.
All included patients were subjected to full history taking and laboratory investigations as complete blood count, total and direct bilirubin, AST, ALT, HBsAg, HCV-Ab, Carcinoemberyonic Ag and Cancer Ag 19.9.
All patients were subjected to radiological investigations as Abdominal Ultrasound and CT abdomen.
According to their presenting complaint, (e.g epigastric pain, vomiting, dysphagia, obstructive jaundice, heamatemesis and elevated tumor markers) and according to the site of the lesion, patients were subjected to either an Upper GI Endoscope or an Endoscopic Retrograde CholangioPancreatography.
All patients were subjected to an Endoscopic Ultrasound using an electronic Pentax linear array machine type EG3830UT adapted to a Hitachi sonographic machine type EUB-5500.
All patients who had upper GI and pancreatic tumors were subjected to an Endoscopic Ultrasound as a preoperative investigation for staging.
Patients with undiagnosed esophageal, gastric, duodenal, and pancreatic masses were subjected to EUS-guided FNA.
The results showed that regarding the presenting complaint of all the 62 patients, more than 48% of the studied cases were presented by obstructive jaundice.
The ERCP findings of 31 patients showed that 29% of the studied cases had swollen papilla, plastic stenting was done to more than 90% of the studied cases.
The EUS findings of all 62 studied patients showed that GastroIntestinal Stromal cell Tumors were detected among 16% of the studied cases, pancreatic mass lesions were detected among 25.8% of the studied cases.
Out of 62 patients who underwent EUS, definitive diagnosis was obtained in 40 patients. The conclusive diagnosis was obtained by using EUS-guided FNA biopsy, cytology and pathology, post operative pathological diagnosis or follow up EUS.
Out of these 40 cases, EUS showed the same diagnosis in 37 cases that were confirmed by the previously stated methods and missed the diagnosis of 3 cases.
In the present study, EUS was found to be more sensitive than abdominal CT in detection of gastro-esophageal, papillary and pancreatic lesions.
In the present study, EUS was found to be more sensitive than ERCP in the diagnosis and staging of papillary and pancreatic mass lesions.
from this study we concluded that EUS has a sensitivity of 96%, a specificity of 85% and an overall accuracy of 92% for the diagnosis of upper GI and pancreatic lesions.