Routine esophagogastroduodenoscopy before upper endoscopic ultrasound for non-luminal indications: clinical value and findings from a large single-center experience.
| Title: | Routine esophagogastroduodenoscopy before upper endoscopic ultrasound for non-luminal indications: clinical value and findings from a large single-center experience. |
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| Authors: | Salam R; Department of Internal Medicine, Henry Ford Providence Hospital, Southfield, Michigan, USA (Reshad Salam, Zachary Bassler).; Bassler Z; Department of Internal Medicine, Henry Ford Providence Hospital, Southfield, Michigan, USA (Reshad Salam, Zachary Bassler).; Hegde Y; Department of Medicine, School of Medicine & Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA (Yash Hegde).; Altahan O; Department of Internal Medicine, Henry Ford Hospital, Detroit, Michigan, USA (Ola Altahan).; Kitchen S; Department of Anesthesiology, Corewell Health William Beaumont University Hospital, Royal Oak, Michigan, USA (Spencer Kitchen).; Sorser S; Department of Gastroenterology, Peak Gastroenterology Associates, Colorado Springs, Colorado, USA (Serge Sorser).; Adler DG; Center for Advanced Therapeutic Endoscopy, Porter Adventist Hospital, Denver, CO, USA (Douglas G. Adler). |
| Source: | Annals of gastroenterology [Ann Gastroenterol] 2025 Nov-Dec; Vol. 38 (6), pp. 720-724. Date of Electronic Publication: 2025 Oct 15. |
| Publication Type: | Journal Article |
| Language: | English |
| Journal Info: | Publisher: The Society Country of Publication: Greece NLM ID: 101121847 Publication Model: Print-Electronic Cited Medium: Print ISSN: 1108-7471 (Print) Linking ISSN: 11087471 NLM ISO Abbreviation: Ann Gastroenterol Subsets: PubMed not MEDLINE |
| Imprint Name(s): | Original Publication: Athens, Greece : The Society, [2000- |
| Abstract: | Background: Most echoendoscopes are oblique viewing instruments, potentially limiting their value in mucosal evaluation during upper endoscopic ultrasound (EUS) examinations. This raises at least the potential for missed mucosal lesions. While esophagogastroduodenoscopy (EGD) prior to EUS may mitigate this, performing EGD adds both cost and time to upper EUS. This study evaluated the utility of routine EGD before EUS in asymptomatic patients.; Methods: We performed a retrospective, single-center, cohort study including 626 patients undergoing EUS for pancreaticobiliary/mediastinal indications over a 5-year period (2017-2022). Exclusion criteria included luminal symptoms or prior upper gastrointestinal surgery. Clinically significant EGD findings and their impact on management were analyzed.; Results: Among 568 patients who underwent EGD before EUS, 16.8% (n=95) had clinically significant lesions, including reflux esophagitis (32.7%), Barrett's esophagus (12.7%) and gastritis (17.3%). Additionally, 16.6% (n=94) exhibited findings affecting the feasibility of EUS (e.g., strictures, large hiatal hernias). Management changes occurred in 54.3% of cases, primarily biopsies (54.3%) and medication initiation (36.6%). Only 4.6% had a prior EGD within 6 months of their EUS.; Conclusions: Routine EGD before EUS can detect clinically significant mucosal lesions in asymptomatic patients, as well as anatomical factors influencing EUS performance. These findings support considering the incorporation of routine EGD into pre-EUS evaluations to optimize diagnostic accuracy and patient management.; (Copyright: © 2025 Hellenic Society of Gastroenterology.) |
| Competing Interests: | Conflict of Interest: None |
| References: | Endosc Int Open. 2016 Feb;4(2):E193-7. (PMID: 26878048); United European Gastroenterol J. 2013 Oct;1(5):329-34. (PMID: 24917980); J Clin Gastroenterol. 2016 Aug;50(7):538-44. (PMID: 26501879); Gastrointest Endosc. 2010 Nov;72(5):967-74. (PMID: 20650452); J Clin Gastroenterol. 2013 Nov-Dec;47(10):857-60. (PMID: 23632349); Endosc Ultrasound. 2019 Jan-Feb;8(1):3-16. (PMID: 30777940) |
| Contributed Indexing: | Keywords: Esophagogastroduodenoscopy; diagnostic accuracy; endoscopic ultrasound; luminal lesions; upper gastrointestinal tract |
| Entry Date(s): | Date Created: 20260126 Date Completed: 20260126 Latest Revision: 20260128 |
| Update Code: | 20260130 |
| PubMed Central ID: | PMC12829533 |
| DOI: | 10.20524/aog.2025.1015 |
| PMID: | 41586400 |
| Database: | MEDLINE |
Journal Article