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   2013| January-March  | Volume 2 | Issue 1  
    Online since September 6, 2013

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Standard imaging techniques for assessment of portal venous system and its tributaries by linear endoscopic ultrasound: A pictorial essay
CS Rameshbabu, Zeeshn Ahamad Wani, Praveer Rai, Almessabi Abdulqader, Shubham Garg, Malay Sharma
January-March 2013, 2(1):16-34
Linear Endosonography has been used to image the Portal Venous System but no established standard guidelines exist. This article presents techniques to visualize the portal venous system and its tributaries by linear endosonography. Attempt has been made to show most of the first order tributaries and some second order tributaries of splenic vein, superior mesenteric vein and portal vein.
  19,383 2,529 2
Endoscopic ultrasound forum summary from the asian pacific digestive week 2012
Pradermchai Kongkam, Benedict M Devereaux, Ryan Ponnudurai, Thawee Ratanachu-ek, Anand V Sahai, Takuji Gotoda, Suthep Udomsawaengsup, Jacques Van Dam, Nonthalee Pausawasdi, Somchai Limsrichemrern, Dong-Wan Seo, Shomei Ryozawa, Yoshiki Hirooka, Yongyut Sirivatanauksorn, Siyu Sun, Sundeep Punamiya, Takao Itoi, Bancha Ovartlanporn, Ichiro Yasuda, Tiing Leong Ang, Hsiu-Po Wang, Khek Yu Ho, Heng Boon Yim, Kenjiro Yasuda, Christopher J.L Khor
January-March 2013, 2(1):43-60
  9,343 589 4
Endobronchial ultrasound for peripheral lesions: A review
Maren Schuhmann, Ralf Eberhardt, Felix J.F Herth
January-March 2013, 2(1):3-6
Lung cancer is one of the most common tumors worldwide. Pulmonary lesions detected during screening for lung cancer need to be evaluated further and tissue should be obtained. Bronchoscopy is often the first step to secure a histological diagnosis. Differ­ent guidance techniques are available to increase the diagnostic yield. Over the last few years endobronchial ultrasound (EBUS) has been used increasingly to direct the sampling tools, often in combination with a guide sheath. This article offers a review of the literature of the use of EBUS in diagnosis of pulmonary peripheral lesions.
  4,040 426 14
Role of endoscopic ultrasound in the diagnosis of pancreas divisum
Surinder Singh Rana, Deepak Kumar Bhasin, Vishal Sharma, Chalapathi Rao, Kartar Singh
January-March 2013, 2(1):7-10
Objective: The published data on the accuracy of the detection of pancreas divisum by endoscopic ultrasound (EUS) is limited. In this study, we evaluate the accuracy of detection of pancreas divisum by radial EUS in patients with chronic pancreatitis. Methods: We retrospectively evaluated patients with chronic pancreatitis who underwent EUS followed by endoscopic retrograde cholangiopancreatography (ERCP) in the last four years to identify patients with complete pancreas divisum. Results: One hundred and forty six patients with chronic pancreatitis underwent EUS examination and 20 patients (13.6%) had pancreas divisum. The overall sensitivity, specificity, positive predictive value, negative predictive value and accuracy of absence of stack sign on EUS for the diagnosis of pancreas divisum were 50%, 97%, 73%, 93% and 91%, respectively and for the inability to trace pancreatic duct from the head to the body were 100%, 96%, 80%, 100% and 96%, respectively. Conclusion: EUS can diagnose pancreas divisum in a majority of patients. Pancreas divisum can be reliably excluded if pancreatic duct could be tracked backwards from the head to the body around the genu.
  3,577 531 8
Endoscopic ultrasound-assisted tunnel-type endoscopic submucosal dissection for the treatment of esophageal tumors arising in the muscularis propria (with video)
Nan Ge, Siyu Sun, Sheng Wang, Xiang Liu, Guoxin Wang, Jintao Guo
January-March 2013, 2(1):11-15
bjective: Esophageal tumors arising in the muscularis propria are difficult to be resected endoscopically using standard electro­surgical techniques, even the endoscopic submucosal dissection (ESD) technique appeared recently. Our purpose is to investigate the efficacy of endoscopic ultrasound (EUS)-assisted tunnel-type ESD for resection of these tumors. Methods: A total of 17 patients were included in this study. A standard endoscope was used. The submucosal tunnel was created with the triangle knife according to the standard ESD technique, about 5 cm proximal to the lesion. EUS was performed within the tunnel to detect the tumor, and then the tumor was separated both from the submucosal and the muscle layers. After the tumor was removed, several clips were used to close the mucosal defect. EUS was performed to evaluate the healing quality 1 week after the procedure. Result: In all the cases, the tumors were completely resected. Mean tumor size was 24.2 mm (12-50 mm) in diameter. The histo­logical diagnoses were leiomyoma (16/17) and gastrointestinal stromal tumor (GIST, 1/17). Subcutaneous emphysema was found in 2 patients after the procedure, but disappeared by the third day. No patients sustained perforation or developed significant hem­orrhage, and there were no other immediate severe complications after the procedure. The healing quality was satisfying in 16/17 patients evaluated by EUS 1 week after the procedure. No recurrence has been found during follow-up (mean 7 months, range 3-13 months). Conclusion: EUS-assisted tunnel-type ESD is effective and safe in treatment of esophageal tumors arising in the muscularis pro­pria.
  2,599 285 6
Endoscopic ultrasound-guided fine needle aspiration for smooth benign appearing esophageal stricture due to metastatic breast cancer
Rei Suzuki, Harvinder Singh, Srinivas Ramireddy, William A Ross, Atsushi Irisawa, Manoop S Bhutani
January-March 2013, 2(1):35-37
Metastatic breast cancer is an uncommon cause of esophageal stricture. We present an 80 year-old woman with past medical history of locally advanced breast cancer who admitted for evaluation of dysphagia. Barium swallow (i.g. esophageal fluoroscopy) demon­strated moderate irregular narrowing in the distal thoracic esophagus. Endoscopy revealed distal esophageal stricture with normal esophageal mucosa and computed tomography demonstrated thickened wall in the distal esophagus and the proximal stomach. Endoscopic biopsy of esophagus revealed no malignancy. Thus, we performed endoscopic ultrasound-guide fine needle aspiration (EUS-FNA) and cytological results were consistent with metastatic breast cancer. Diagnosis of malignant esophageal stricture due to metastasis from other primary is often challenging and requires a high index of suspicion. EUS-FNA is an alternative diagnostic technique in such cases when endoscopic biopsy fails to obtain adequate specimen.
  2,337 188 3
Pancreatic Tuberculosis Mimicking Malignancy Diagnosed with Endoscopic Ultrasound-Guided Fine Needle Aspiration
Devi Patel, David Loren, Thomas Kowalski, Ali A Siddiqui
January-March 2013, 2(1):38-40
A female presented to the physician with a history of right upper quadrant pain. Abdominal computed tomography (CT) scan dem­onstrated a multi-loculated solid lesion in the head of the pancreas concerning for a primary malignancy. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) of the lesion was performed and cytology revealed no evidence of malignancy. The acid-fast bacilli culture was found to be positive for Mycobacterium tuberculosis complex and pancreatic tuberculosis was diagnosed.
  1,854 209 6
Endoscopic ultrasound-guided confocal microscopy: A new tool for the new year?
Marc Giovannini
January-March 2013, 2(1):1-2
  1,641 241 1
Pancreatic adenocarcinoma with early intense enhancement in harmonic contrast-endoscopic ultrasound and high strain ratio in elastometry (with video)
Fabrice Caillol, Domenico Galasso, Erwan Bories, Christian Pesenti, Flora Poizat, Genevieve Monges, Marc Giovannini
January-March 2013, 2(1):41-42
  1,614 181 -