Endoscopic ultrasound (EUS) is often requested in patients in whom computed tomography (CT) shows gastric wall thickening.
It is unclear if EUS is useful if upper endoscopy is normal.
Dr Eric Lam and colleagues from Canada prospectively compared the yields of upper endoscopy with EUS for this indication.
|If endoscopy was normal, EUS was normal in 100% of cases|
|The American Journal of Gastroenterology|
The research team evaluated 69 patients referred for endoscopic ultrasound because of thickened gastric folds on CT between 2001 and 2003.
The average age of the participants was 57 years, and 49% were male.
Of the participants included, 51% were asymptomatic, 57% had normal upper endoscopy, and 70% had normal EUS.
A single physician questioned, examined, and performed upper endoscopy followed by EUS in all patients.
The researchers assessed upper endoscopy and EUS findings, and predictors of abnormal EUS.
If upper endoscopy was abnormal, EUS was abnormal in 70% of cases.
The team found that if upper endoscopy was normal, the EUS was normal in 100% of cases.
Multivariate analysis revealed that neither age, gender, presence of abdominal symptoms nor alarm symptoms predicted abnormal EUS.
Dr Lam's team concluded that, "When CT shows gastric wall thickening, normal upper endoscopy is strongly associated with normal EUS."
"Abnormal upper endoscopy is associated with abnormal EUS in 70% of cases."
"Clinical variables such as age, sex, and the presence of symptoms do not predict or increase the likelihood of abnormal EUS".
"Therefore, in patients with thickened gastric wall on CT, upper endoscopy should be used to select patients for EUS."