Question

Describe structures visualized in EUS at various GI stations: i) GE junction.
ii) Pylorus.
ii) Pylorus.

Hint:

EUS is highly valuable in visualizing the gastrointestinal tract, providing critical insights into conditions affecting the esophagus, stomach, and duodenum.

Answer 1

The gastroesophageal (GE) junction is the area where the esophagus meets the stomach. In endoscopic ultrasound (EUS), this structure is visualized as a complex interface between the esophageal mucosa and the gastric mucosa. It is important in assessing conditions such as gastroesophageal reflux disease (GERD), esophageal cancers, and achalasia. Key Features:
- The GE junction appears as a hypoechoic area where the esophagus and stomach meet.
- EUS can identify abnormalities such as hiatal hernias, gastric mucosal changes, and esophageal varices. ii) Pylorus.
The pylorus is the region of the stomach that connects to the duodenum, controlling the passage of food. On EUS, the pylorus is visualized as a thick muscular region that serves as a barrier between the stomach and the small intestine. Key Features:
- The pyloric sphincter appears as a hypoechoic ring in the distal stomach, which regulates gastric emptying.
- EUS can assess pyloric stenosis, particularly in infants, and other abnormalities like gastric outlet obstruction. iii) Duodenum 1st part.
The first part of the duodenum is the proximal segment of the small intestine, located immediately after the pylorus. On EUS, the duodenum appears as a smooth, hypoechoic structure with clear differentiation from the surrounding tissues. Key Features:
- The first part of the duodenum can be assessed for conditions such as peptic ulcer disease, duodenal stenosis, and malignancies.
- EUS can visualize the duodenal wall layers, allowing for the detection of abnormalities such as tumors or pancreatitis.