The Use of Endoscopic Ultrasonography for the Diagnosis of Peptic Ulcers and the Detection of Intractable Ulcers Kenjiro Yasuda 1 , Keisuke Kiyota 1 , Eisai Cho 1 , Masatsugu Nakajima 1 1Department of Gastroenterology, Kyoto Second Red Cross Hospital pp.511-518
Published Date 1988/5/25
DOI https://doi.org/10.11477/mf.1403108123
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 Endoscopic ultrasonography (EUS) was performed on 80 patients with peptic ulcers of the stomach. Eighty cases of peptic ulcer were examined before and/or after treatment one or more times each for a total of 128 examinations using EUS. This was done in order to study the clinical course of peptic ulcers, and to detect intractable ulcers.

 This study was based on the analysis of the 5-layerd structure of the gastric wall observed by EUS. In the EUS images, we were able to detect not only the depth of ulcerative defects but also the characteristic images of each stage of the ulcer. Endoscopically, in the active stage of the ulcer, the swelling of both sides of the ulcerative wall caused by hypoechoic edema was detectable in the layered structure. In the healing stage, the swelling of the wall disappeared and the defect grew smaller. In the scanning of the early stage, the defect of the ulcer disappeared showing the tapered submucosal layer with or without the appearance of the hypoechoic mass of fibrosis beneath the submucosal layer. In the late scarring stage, each layer tapered to the center of the scar. Recurrent ulcer showed a defect in the hypoechoic gastric wall with the EUS image of fusion. Intractable ulcers were observed to have hypoechoic masses of fibrosis.

 As mentioned above, EUS diagnosis of peptic ulcer was useful in the evaluation of the clinical course of peptic ulcers and intractable ulcers. However, at present, it is difficult to evaluate the volume of the hypoechoic mass of fibrosis objectively. Further investigation with respect to this problem is necessary for a precise diagnosis of intractable ulcers.

Copyright © 1988, Igaku-Shoin Ltd. All rights reserved.


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