title: Percutaneous ultrasound-guided bowel wall core biopsy: a nonconventional way of diagnosis of gastrointestinal lesions.
abstract: BACKGROUND
  Patients with gastrointestinal lesions; unsuccessfully diagnosed by endoscopy are challenging to gastroenterologists. We aimed to study the role and safety of ultrasound, its guided biopsy in visualizing and diagnosing these bowel lesions.
  
  
  METHODS
  Sixty-three patients with endoscopically and/or imaging documented gastrointestinal lesions were prospectively enrolled. All had detailed high-frequency (5-8 MHz) transabdominal bowel ultrasound examination to identify, localize and characterize the lesions, which were further biopsied using ultrasound guidance.
  
  
  RESULTS
  Lesions were histo-pathologically diagnosed; 57 (90.5%) were malignant and 6 (9.5%) were benign. Ultrasound was able to localize all the lesions. They were characterized as focal in 12 (19.1%) and diffuse bowel wall involvement in 51 (80.9%) patients. Ultrasound was capable of suggesting the nature of diffuse bowel involvement whether benign or malignant in 94.1%. Comparing malignant diffuse bowel lesions and benign ones; the former had greater mean wall thickness (2.2 vs. 1.1 cm), loss of layering pattern (87.2 vs. 50%), asymmetrical pattern of involvement (78.7 vs. 0%), short length of affected segment (87.2 vs. 50%) and paucity of perilesional findings. Ultrasound-guided core biopsy was diagnostic in 60 (95.2%) patients with no reported complications. Diagnostic laparotomy was resorted to in 3 (4.8%). Ultrasound-guided bowel wall core biopsy had sensitivity of 98.2% in diagnosing malignant lesions and specificity of 66.6% in benign lesions.
  
  
  CONCLUSIONS
  High-frequency transabdominal ultrasound and ultrasound-guided core biopsy of bowel lesions are potentially safe and effective diagnostic methods in select gastrointestinal lesions whenever conventional endoscopic diagnosis was unsuccessful, thus avoiding unnecessary diagnostic surgical procedures.
authors.affiliation: Department of Endemic Medicine and Hepatogastroenterology, Faculty of Medicine, Kasr Al-Aini Hospital, Cairo University, Cairo 11562, Egypt. mahahasaballah@yahoo.com
authors.forename: M S
authors.initials: MS
authors.lastname: Hasab Allah
authors.forename: A A
authors.initials: AA
authors.lastname: El-Hindawy
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D001707:Biopsy, Needle / Q000379:methods*; D003937:Diagnosis, Differential; D016099:Endoscopy, Gastrointestinal; D005260:Female; D005770:Gastrointestinal Neoplasms / Q000000981:diagnostic imaging / Q000473:pathology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D018084:Ultrasonography, Interventional