Skip to main content
Volume 6, No 4 - Fall 2006

Volume 6, No 4 - Fall 2006

Table of Contents

The Expanding Role of Endoscopic Ultrasound in Pancreatic Disease Technique Update
Since endoscopic ultrasound (EUS) was first developed in the 1980s, this technology has emerged as the principal modality for imaging the pancreas. When compared with other imaging techniques, EUS can more accurately image solid lesions of the pancreas and determine vascular involvement that might preclude surgery. Furthermore, EUS-guided fine needle aspiration allows safe and accurate sampling and histological diagnosis of these lesions. EUS also plays a large role in the evaluation of cystic lesions of the pancreas. EUS cyst morphology, as well as fluid analysis obtained by fine needle aspiration, can often be used to diagnose the etiology of these lesions, helping the clinician to more accurately assess the presence or potential for malignancy. EUS can also predict the probability of the presence of chronic pancreatitis, primarily on the basis of histological correlates. The focus of this review is to discuss the role of EUS in these and other commonly encountered pancreatic diseases. [Rev Gastroenterol Disord. 2006;6(4):201-208]
Chromoendoscopy and Its Alternatives for Colonoscopy: Useful in the United States? Technique Review
American endoscopists have essentially ignored chromoendoscopy (dye spraying) in the colon and overwhelmingly perform white-light colonoscopy only. The published studies suggest that routine use of chromoendoscopy in Western populations will lead to identification of additional flat lesions. However, a number of these studies have design flaws. The authors’ interpretation of the existing data is that pancolonic chromoendoscopy to detect flat and depressed lesions is not yet proven as a useful and therefore necessary adjunct to routine colonoscopic examination in non-inflammatory bowel disease patients in the United States. Chromoendoscopy, particularly combined with magnification, is very effective in delineating the pit pattern of polyps and in allowing real-time differentiation of adenomatous from nonadenomatous lesions. There might be a role for chromoendoscopy with high magnification in the delineation of unresected portions of lateral spreading tumors being removed by piecemeal polypectomy and in the evaluation of polypectomy scars during endoscopic follow-up. The authors suggest that US endoscopists begin to familiarize themselves with shape classification, and that they learn a method to determine histology in real time. [Rev Gastroenterol Disord. 2006;6(4):209-220]
The Prevention of Gastropathy and Upper Abdominal Symptoms Caused By Nonsteroidal Anti-Inflammatory Drugs Treatment Review
The use of nonsteroidal anti-inflammatory drugs (NSAIDs) is increasing, primarily due to arthritis in the aging population. This article reviews current data on the risk of gastrointestinal complications related to NSAIDs and strategies to manage risk in patients taking these agents. Risks of NSAID use include gastrointestinal ulceration, hemorrhage, or perforation; renal dysfunction; death; and dyspepsia. Alternate therapies include use of non- NSAID analgesics; low-dose NSAIDs; and concurrent administration of cytoprotective agents with NSAIDs, acid inhibitors, proton pump inhibitors, and COX-2 agents. [Rev Gastroenterol Disord. 2006;6(4):221-226]
Report from the ACG Meeting Review
Highlights of the 71st Annual Scientific Meeting of the American College of Gastroenterology October 20-25, 2006 Las Vegas, NV [Rev Gastroenterol Disord. 2006;6(4):227-242]