title: Endoscopic Doppler US probe for the diagnosis of gastric varices (with videos).
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.
  
  
  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.
authors.affiliation: Division of Gastroenterology, Department of Medicine, University Hospitals Case Medical Center, 11100 Eucl;id Avenue, Cleveland, OH 44106, USA.
authors.forename: Richard C K
authors.initials: RC
authors.lastname: Wong
authors.forename: Farees T
authors.initials: FT
authors.lastname: Farooq
authors.forename: Amitabh
authors.initials: A
authors.lastname: Chak
mesh_terms: 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