Endoscopic Ultrasound in the Evaluation of Chronic Upper Abdominal Pain of Unknown Etiology

Thompson, Michelle; Ramírez, Jonathan; Rosa, Lisa M. De La; Wood, Adam S.; Desai, S.C.; Arjunan, Ananth; Song, Juhee; Erickson, Richard A.

doi:10.1097/mcg.0000000000000174

Cited by 2 publications

(1 citation statement)

References 12 publications

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“…Additionally, E-DUS has been presented as superior to TA-DUS in detecting other diseases of the persistent upper abdominal pain. 28 , 29 …”

Section: Discussionmentioning

confidence: 99%

Early Identification of Chronic Mesenteric Ischemia with Endoscopic Duplex Ultrasound

Safi¹,

Ånonsen²,

Berge³

et al. 2022

VHRM

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Introduction Due to diagnostic delay, chronic mesenteric ischemia (CMI) is underdiagnosed. We assumed that the patients suspected of CMI of the atherosclerotic origin or median arcuate ligament syndrome (MALS) could be identified earlier with endoscopic duplex ultrasound (E-DUS). Patients and Methods Fifty CMI patients with CTA-verified stenosis of either ≥50% and ≥70% of celiac artery (CA) and superior mesenteric artery (SMA) were examined with E-DUS and transabdominal duplex ultrasound (TA-DUS). Peak systolic velocities (PSV) of ≥200cm/s and ≥275cm/s for CA and SMA, respectively, were compared with CTA. Subgroup analysis was performed for the patients with (n=21) and without (n=29) prior revascularization treatment of CMI. The diagnostic ability of E-DUS and TA-DUS was tested with crosstabulation analysis. Receiver operating characteristics (ROC) curve analysis was performed, and the area under the curve (AUC) was calculated to investigate the test accuracy. Results In the patients with ≥70% stenosis, E-DUS had higher sensitivity than TA-DUS (91% vs 81% for CA and 100% vs 92% for SMA). AUC for SMA ≥70% in E-DUS was 0.75 and with TA-DUS 0.68. The sensitivity of E-DUS for CTA-verified stenosis ≥70% for CA was 100% in the patients without prior treatment. E-DUS demonstrated higher sensitivity than TA-DUS for both arteries with stenosis ≥50% and ≥70% in the treatment-naive patients. Conclusion E-DUS is equally valid as TA-DUS for the investigation of CMI patients and should be used as an initial diagnostic tool for patients suspected of CMI.

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“…Additionally, E-DUS has been presented as superior to TA-DUS in detecting other diseases of the persistent upper abdominal pain. 28 , 29 …”

Section: Discussionmentioning

confidence: 99%

Early Identification of Chronic Mesenteric Ischemia with Endoscopic Duplex Ultrasound

Safi¹,

Ånonsen²,

Berge³

et al. 2022

VHRM

View full text Add to dashboard Cite

show abstract

Upper Abdominal Pain

Mizuno

Hanaoka

2020

Chronic Pain Management in General and Hospital Practice

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Endoscopic Ultrasound in the Evaluation of Chronic Upper Abdominal Pain of Unknown Etiology

Abstract: Our results support the fact that the majority of patients UAP with prior imaging will have no identifiable organic etiology found on EUS to explain their pain; however, we suggest that EUS be considered in patients with suspected pancreatic or biliary pathology.

Cited by 2 publications

References 12 publications

Early Identification of Chronic Mesenteric Ischemia with Endoscopic Duplex Ultrasound

Early Identification of Chronic Mesenteric Ischemia with Endoscopic Duplex Ultrasound

Upper Abdominal Pain

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