Accuracy Of Endoscopic Ultrasound In Diagnosis Of Upper Gastrointestinal Diseases

Endoscopic ultrasound (EUS) is a useful technique to diagnose lesions hat are located in the upper gastrointestinal tract. Aassessment the accuracy of. endoscopic ultrasound in the diagnosis of upper gastrointestinal diseases in comparison to other imaging techniques in Egypt. 62 patients with upper gastrointestinal and pancreatic lesions who underwent EUS for further detection or confirmation of the diagnosis. The participants were subjected to full history taking, clinical examination, laboratory tests (S. albumin,. ALT,AST,CBC, ... etc). abdominal ultrasound and abdominal computed tomography. Endoscopy was done according to the presenting complaint and site of lesion, patients were subjected to either an upper gastrointestinal (GIT) endoscopy or an endoscopic retrograde cholangiopancreatography (ERCP). The included patients were 36 males (58.1%) and 26 females (41.9%) with mean age 51.84 +/- 13.39 years. Obstructive jaundice was the most common presenting complaint (30 patients, 48.4%), vomiting (9 patients, 14.5%), hematemesis (8 patients, 12.9%), epigastric pain (6 patients, 7 dysphagia (3 patients, 4.8%), and elevated tumor markers (3 patients, 4.8%). CT was more accurate in detecting pancreatic lesions especially focal lesions in head of pancreas. EUS was significantly more accurate than abdominal CT in diagnosing esophageal and gastric submucosal lesions, 15 patients all were detected by EUS (100%) while only 9 patients were detected by using abdominal CT (60%) (x(2)4.7, p < 0.05). Out of 40 cases confirmed diagnosis by histopathology, EUS alone missed 3 cases with sensitivity 96%, specificity 85%, PPV 92%, NPV 92% and accuracy 92% in detecting upper gastrointestinal and pancreatic lesions. EUS is a sensitive diagnostic tool of upper GI and pancreatic lesions with overall accuracy of 92%.