title: The role of endoscopic ultrasound in the evaluation of chronic mesenteric ischaemia.
abstract: BACKGROUND
  Doppler transabdominal ultrasound is a validated screening test for chronic mesenteric ischaemia, but gas and obesity are limitations. Endoscopic ultrasound has been proposed as a comprehensive test to evaluate chronic upper abdominal pain and is capable of Doppler measurement. We aim to evaluate the accuracy of Doppler endoscopic ultrasound (D-EUS) as a single screening test to rule out chronic mesenteric ischaemia in patients with abdominal pain and compare it with Doppler transabdominal ultrasound (D-TUS).
  
  
  METHODS
  We enrolled all patients ≥50 years with chronic upper abdominal pain and vascular risk referred for endoscopic ultrasound. All were scheduled for D-EUS and D-TUS plus a confirmatory test if one of the previous resulted positive. We estimated the accuracy of both techniques comparing them using McNemar test.
  
  
  RESULTS
  68 patients completed the study. Fifty-three (78%) underwent D-EUS, D-TUS, and a confirmatory test. Fifteen (38%) underwent follow-up after negative results. Three (4%) in the D-EUS group and 14 in the D-TUS (21%) were excluded due to artefacts. D-EUS presented a sensitivity of 63%, specificity of 84%, whilst D-TUS presented a sensitivity of 80% and a specificity of 78%. Specificity of D-EUS was not significantly different to D-TUS.
  
  
  CONCLUSIONS
  These results support the role of Doppler endoscopic ultrasound to exclude chronic mesenteric ischaemia as cause of chronic abdominal pain.
authors.affiliation: Division of Gastroenterology and Hepatology, Mayo Clinic Florida, Jacksonville, FL, USA.
authors.forename: Cristina
authors.initials: C
authors.lastname: Almansa
authors.forename: Helga
authors.initials: H
authors.lastname: Bertani
authors.forename: Kyung W
authors.initials: KW
authors.lastname: Noh
authors.forename: Michael B
authors.initials: MB
authors.lastname: Wallace
authors.forename: Timothy A
authors.initials: TA
authors.lastname: Woodward
authors.forename: Massimo
authors.initials: M
authors.lastname: Raimondo
mesh_terms: D015746:Abdominal Pain / Q000000981:diagnostic imaging / Q000209:etiology*; D000368:Aged; D000369:Aged, 80 and over; D002908:Chronic Disease; D003937:Diagnosis, Differential; D019160:Endosonography / Q000379:methods*; D005260:Female; D006801:Humans; D007511:Ischemia / Q000150:complications / Q000000981:diagnostic imaging*; D008297:Male; D008638:Mesenteric Arteries / Q000000981:diagnostic imaging / Q000473:pathology; D008641:Mesenteric Vascular Occlusion / Q000150:complications / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010865:Pilot Projects; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018608:Ultrasonography, Doppler