الفهرس 
Mohamed Al-Gharib Abo Al-MaatyOnly 14 pages are availabe for public view
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Abstract
Gastric endosonography has a technical principle of using both high frequency ultrasound probes with endoscopies to achieve systemic assessment of the structural wall of the stomach.
The wall of the stomach can be imaged as five layer structure of alternating bright and dark bands. This bands can be correlated with the histological structure of the stomach wall.
This benefit was not allowed by using endoscopy alone or by using other imaging techniques. In addition the investigators should be trained on both endoscopy and ultrasonography.
Indications of gastric endosonography:
• Detection of tumor site of origin, whether it arises from gastric mucosa or from any other gastric wall layer and if it is intra or extra mural tumor.
• Staging and follow up of gastric carcinoma:
EUS is of benefit in local staging of gastric cancer and in evaluating the therapeutic effect of the disease.
• Staging and follow up of gastric lymphoma:
EUS has a good role in the assessment of progression and regression of lymphatic tumors in gastric wall. So it is of benefit in assessment of chemotherapy effects in gastric lymphoma. In addition, EUS helps in diagnosis and treatment of gastric MALT lymphoma after eradication of H. pylori.
• Diagnosis of Portal hypertension and gastric varices:
• EUS-FNAB permits real time ultrasonography guided aspiration biopsy of intramural or extra mural lesions leading to obtaining of samples for diagnostic cytologic analysis. The results obtained by these samples potentially affect clinical decision making.
• 3D-EUS may have a good role in gastrointestinal tract tumors in general, but its using in gastric tumors is still limited mainly for volume assessment. Clinical applications of 3D- EUS are still in their early stage of development and additional clinical research remains to be carried out.
Contraindications and complications of gastric endosonography:
EUS shouldn’t be conducted in patients with cardio-pulmonary disease, because of the effect of the anesthetic premedications. Great care should be taken in patients with necrotic esophageal tumors, as the tissues may obstruct the endoscopic field of view. The endoscope should be inserted with care for fear of perforation. Forceful insertion should be avoided as there is a risk of injury to esophageal diverticulum. Gastroscope should done prior to EUS.