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Case Reports
. 2007 Mar;65(3):491-6.
doi: 10.1016/j.gie.2006.11.017.

Endoscopic Doppler US Probe for the Diagnosis of Gastric Varices (With Videos)

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Case Reports

Endoscopic Doppler US Probe for the Diagnosis of Gastric Varices (With Videos)

Richard C K Wong et al. Gastrointest Endosc. .

Abstract

Background: Gastric varices may appear similar to enlarged gastric folds and submucosal neoplasms at endoscopy. A simple endoscopic method to diagnose variceal blood flow without formal EUS could be clinically useful.

Objective: To demonstrate the use of Doppler US (DOP-US) in the diagnosis of gastric varices.

Design: Case series.

Setting: A tertiary-care U.S. academic medical center.

Patients: Eight patients with findings of gastric submucosal lesions of uncertain etiology on EGD.

Interventions: EGD with DOP-US examination, with or without standard EUS.

Main outcome measurements: Presence or absence of audible DOP-US signal and EUS findings for gastric submucosal lesions.

Results: DOP-US demonstrated a reproducible continuous venous hum in 5 cases of gastric varices (confirmed by EUS in 2 cases). A sixth case of gastric varices demonstrated pulsatile flow with DOP-US (confirmed by EUS). In 1 case of a GI stromal tumor (GIST) in the stomach, no signal was heard when the lesion itself was examined by DOP-US. In a final case of Menetrier's disease, no signal was heard when the giant gastric folds were examined.

Conclusions: DOP-US can help differentiate gastric varices from other gastric submucosal lesions. The use of DOP-US may obviate the need for EUS to confirm gastric varices when the EGD diagnosis is uncertain.

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