Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging

Detalhes bibliográficos
Autor(a) principal: Ardengh,José Celso
Data de Publicação: 2011
Outros Autores: Vaiciunas,Spencer, Kemp,Rafael, Venco,Filadelfo, Lima-Filho,Éder Rios, Santos,José Sebastião dos
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Arquivos de gastroenterologia (Online)
Texto Completo: http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032011000400004
Resumo: CONTEXT: The identification of a bulging covered by normal epithelium is a common finding during an upper gastrointestinal endoscopy. OBJECTIVE: To compare the endoscopic and endosonography findings in the differential diagnosis of the gastrointestinal bulging (subepithelial tumor or extrinsic compression). METHOD: Patients referred by endosonography with bulging of upper gastrointestinal tract were studied retrospectively. The size, location, consistency and presumptive diagnosis were recorded at time of endoscopy and endosonography. Endosonography-guided fine-needle aspiration was proposed in case of uncertain diagnose to increase diagnostic sensitivity. RESULTS: One hundred seventy-six patients (93 women) and mean age 62.5 years (10-87). One hundred fifty-three had subepithelial tumor and 23 had extrinsic compression as a final diagnosis. Endosonography had sensitivity, specificity and accuracy higher than those found by endoscopy for both diagnosis subepithelial tumor and extrinsic compression. Endoscopy and endosonography showed poor concordance (K = 0.13) for subepithelial tumor diagnosis and unsuitable agreement for diagnosis in extrinsic compression (K = 0.01). The endosonography-guided fine-needle aspiration had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 75%, 72.4%, 80.5%, 65.6% and 74%, respectively. CONCLUSION: Endoscopy has high sensitivity and low specificity for subepithelial tumor and both are low for the extrinsic compression. Endoscopy is a good tool for diagnosis of the subepithelial tumors, but not to determine the cause of an extrinsic compression. The endosonography identifies the layer from which subepithelial tumor comes, obtain histological samples, and increasing the diagnostic accuracy.
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spelling Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulgingEndoscopy, gastrointestinalEndosonographyGastrointestinal neoplasmsCONTEXT: The identification of a bulging covered by normal epithelium is a common finding during an upper gastrointestinal endoscopy. OBJECTIVE: To compare the endoscopic and endosonography findings in the differential diagnosis of the gastrointestinal bulging (subepithelial tumor or extrinsic compression). METHOD: Patients referred by endosonography with bulging of upper gastrointestinal tract were studied retrospectively. The size, location, consistency and presumptive diagnosis were recorded at time of endoscopy and endosonography. Endosonography-guided fine-needle aspiration was proposed in case of uncertain diagnose to increase diagnostic sensitivity. RESULTS: One hundred seventy-six patients (93 women) and mean age 62.5 years (10-87). One hundred fifty-three had subepithelial tumor and 23 had extrinsic compression as a final diagnosis. Endosonography had sensitivity, specificity and accuracy higher than those found by endoscopy for both diagnosis subepithelial tumor and extrinsic compression. Endoscopy and endosonography showed poor concordance (K = 0.13) for subepithelial tumor diagnosis and unsuitable agreement for diagnosis in extrinsic compression (K = 0.01). The endosonography-guided fine-needle aspiration had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 75%, 72.4%, 80.5%, 65.6% and 74%, respectively. CONCLUSION: Endoscopy has high sensitivity and low specificity for subepithelial tumor and both are low for the extrinsic compression. Endoscopy is a good tool for diagnosis of the subepithelial tumors, but not to determine the cause of an extrinsic compression. The endosonography identifies the layer from which subepithelial tumor comes, obtain histological samples, and increasing the diagnostic accuracy.Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE. 2011-12-01info:eu-repo/semantics/articleinfo:eu-repo/semantics/publishedVersiontext/htmlhttp://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032011000400004Arquivos de Gastroenterologia v.48 n.4 2011reponame:Arquivos de gastroenterologia (Online)instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiainstacron:IBEPEGE10.1590/S0004-28032011000400004info:eu-repo/semantics/openAccessArdengh,José CelsoVaiciunas,SpencerKemp,RafaelVenco,FiladelfoLima-Filho,Éder RiosSantos,José Sebastião doseng2011-11-28T00:00:00Zoai:scielo:S0004-28032011000400004Revistahttp://www.scielo.br/aghttps://old.scielo.br/oai/scielo-oai.php||secretariaarqgastr@hospitaligesp.com.br1678-42190004-2803opendoar:2011-11-28T00:00Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologiafalse
dc.title.none.fl_str_mv Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
title Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
spellingShingle Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
Ardengh,José Celso
Endoscopy, gastrointestinal
Endosonography
Gastrointestinal neoplasms
title_short Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
title_full Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
title_fullStr Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
title_full_unstemmed Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
title_sort Upper endoscopy versus endosonography in differential diagnosis of gastrointestinal bulging
author Ardengh,José Celso
author_facet Ardengh,José Celso
Vaiciunas,Spencer
Kemp,Rafael
Venco,Filadelfo
Lima-Filho,Éder Rios
Santos,José Sebastião dos
author_role author
author2 Vaiciunas,Spencer
Kemp,Rafael
Venco,Filadelfo
Lima-Filho,Éder Rios
Santos,José Sebastião dos
author2_role author
author
author
author
author
dc.contributor.author.fl_str_mv Ardengh,José Celso
Vaiciunas,Spencer
Kemp,Rafael
Venco,Filadelfo
Lima-Filho,Éder Rios
Santos,José Sebastião dos
dc.subject.por.fl_str_mv Endoscopy, gastrointestinal
Endosonography
Gastrointestinal neoplasms
topic Endoscopy, gastrointestinal
Endosonography
Gastrointestinal neoplasms
description CONTEXT: The identification of a bulging covered by normal epithelium is a common finding during an upper gastrointestinal endoscopy. OBJECTIVE: To compare the endoscopic and endosonography findings in the differential diagnosis of the gastrointestinal bulging (subepithelial tumor or extrinsic compression). METHOD: Patients referred by endosonography with bulging of upper gastrointestinal tract were studied retrospectively. The size, location, consistency and presumptive diagnosis were recorded at time of endoscopy and endosonography. Endosonography-guided fine-needle aspiration was proposed in case of uncertain diagnose to increase diagnostic sensitivity. RESULTS: One hundred seventy-six patients (93 women) and mean age 62.5 years (10-87). One hundred fifty-three had subepithelial tumor and 23 had extrinsic compression as a final diagnosis. Endosonography had sensitivity, specificity and accuracy higher than those found by endoscopy for both diagnosis subepithelial tumor and extrinsic compression. Endoscopy and endosonography showed poor concordance (K = 0.13) for subepithelial tumor diagnosis and unsuitable agreement for diagnosis in extrinsic compression (K = 0.01). The endosonography-guided fine-needle aspiration had sensitivity, specificity, positive predictive value, negative predictive value and accuracy of 75%, 72.4%, 80.5%, 65.6% and 74%, respectively. CONCLUSION: Endoscopy has high sensitivity and low specificity for subepithelial tumor and both are low for the extrinsic compression. Endoscopy is a good tool for diagnosis of the subepithelial tumors, but not to determine the cause of an extrinsic compression. The endosonography identifies the layer from which subepithelial tumor comes, obtain histological samples, and increasing the diagnostic accuracy.
publishDate 2011
dc.date.none.fl_str_mv 2011-12-01
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032011000400004
url http://old.scielo.br/scielo.php?script=sci_arttext&pid=S0004-28032011000400004
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv 10.1590/S0004-28032011000400004
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv text/html
dc.publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE.
publisher.none.fl_str_mv Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia e Outras Especialidades - IBEPEGE.
dc.source.none.fl_str_mv Arquivos de Gastroenterologia v.48 n.4 2011
reponame:Arquivos de gastroenterologia (Online)
instname:Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia
instacron:IBEPEGE
instname_str Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia
instacron_str IBEPEGE
institution IBEPEGE
reponame_str Arquivos de gastroenterologia (Online)
collection Arquivos de gastroenterologia (Online)
repository.name.fl_str_mv Arquivos de gastroenterologia (Online) - Instituto Brasileiro de Estudos e Pesquisas de Gastroenterologia
repository.mail.fl_str_mv ||secretariaarqgastr@hospitaligesp.com.br
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