Stomach endoscopic ultrasound

Fig. 2.15a,b. Leiomyoma of the stomach. Double Contrast barium study (a) shows a well delineated smooth mass arising from the lesser curve of the stomach. Endoscopic-ultrasound (b) demonstrates a massive lesion which does not penetrate through the gastric wall. Biopsy revealed a benign leiomyoma... 

While sonography and hydrosonography of the stomach may detect gastric cancer (Ch. 16), gastric submucosal tumours (Ch. 19) and gastroduodenal ulcers, it can not be used for routine assessment of the stomach in dyspeptic patients, endoscopy and endoscopic ultrasound being much more accurate diagnostic tools (Fig. 21.1). 

Fig. 2.9a-e. Leiomyosarcoma of the stomach Double Contrast barium study (A) shows a large bulky mass, protruding into the lumen of the body of the stomach, covered with normal mucosa. Note the deep ulceration at the caudal side of the tumour, commonly seen with larger leiomyomas (GlSTs) and leiomyosarcomas. Endoscopy (b,c) demonstrates the upper and lower borders of the well delineated mass, with the ulcer clearly seen with retroversion of the endoscope (b). Endoscopic ultrasound (d) shows that the mass does not penetrate through the muscularis mucosae of the stomach wall. Histopathol-ogy of the resection specimen (e) is taken through the level of the ulcer in the leiomyosarcoma... 

Fig. 2.20a-d. Gastric Polyp. Double Contrast barium study (a) demonstrates a large pedunculated polyp in the antrum of the stomach. Endoscopy (b) and Endoscopic-ultrasound (c) confirm the pedunculated polyp which was confirmed as a non ulcerated fibroid polyp on histopathology (d)... 

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