Endoscopic Doppler US probe for the diagnosis of gastric varices (with videos).
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.


METHODS
Case series.


METHODS
A tertiary-care U.S. academic medical center.


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


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


METHODS
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.
Wong
Richard C K
RC
Division of Gastroenterology, Department of Medicine, University Hospitals Case Medical Center, 11100 Eucl;id Avenue, Cleveland, OH 44106, USA.
Farooq
Farees T
FT
Chak
Amitabh
A
D000368:Aged; D001783:Blood Flow Velocity / Q000502:physiology; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D004867:Equipment Design; D004932:Esophageal and Gastric Varices / Q000000981:diagnostic imaging* / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018608:Ultrasonography, Doppler / Q000295:instrumentation*; D014741:Video Recording