Diagnosis

Endoscopic diagnostic criteria (Fig. 3.93)

► Hemispherical protrusion

► Small central depression may be present

► Mucosa intact or ulcerated (especially with large tumors)

► Mucosa can be lifted from the tumor (tented) with forceps due to the intramural tumor attachment.

► "Bridging folds" may be seen on opposite sides of the protrusion.

Differential diagnosis

► Extrinsic indentation

Checklist for endoscopic evaluation

Additional Studies

► Endosonography

► Cytological aspiration during endosonography

► Buttonhole biopsy: should be used very sparingly, as it can cause significant bleeding. Also, it is contraindicated if enu-cleation is planned.

Fig. 3.93 Intramural tumors of the stomach

Fig. 3.93 Intramural tumors of the stomach

Intramural leiomyoma with superficial mucosal ulceration b Intramural lipoma a

Intramural leiomyoma with superficial mucosal ulceration b Intramural lipoma

c, d Indeterminate submucosal mass in the stomach wall

e Overgrown PEG tube, presenting as an intramural mass

TO U

Was this article helpful?

0 0

Post a comment