Endoscopic ultrasound-guided fine-needle aspiration of ascites.

Endoscopic ultrasound-guided fine-needle aspiration of ascites. Research Abstract Details 

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Endoscopic ultrasound-guided fine-needle aspiration of ascites. Abstract Text:

John DeWitt,Julia LeBlanc,Lee McHenry,Kathy McGreevy,Stuart Sherman,John DeWitt,Julia LeBlanc,Lee McHenry,Kathy McGreevy,Stuart Sherman,

BACKGROUND & AIMS: The aim of this study is to report a large single-center experience with endoscopic ultrasound (EUS)-guided fine-needle aspiration (FNA) of ascites. METHODS: Consecutive patients at our institution in whom EUS-guided paracentesis was performed between January 1997 and July 2005 were identified retrospectively. All procedures were performed by or under the supervision of 1 of 5 experienced endosonographers with available on-site cytopathology. RESULTS: Sixty consecutive patients (33 men; mean age, 67 y) were identified. Previously attempted percutaneous paracentesis was unsuccessful in 3 of 6 patients. Ascites confirmed by EUS FNA was visible in 28 of 54 (52%) computerized tomography, 3 of 11 (27%) transabdominal ultrasound, and 4 of 8 (50%) magnetic resonance imaging examinations before EUS. Transgastric (n = 55) or transduodenal (n = 5) EUS-guided paracentesis (mean, 8.9; range, 1-40 mL) revealed malignancy in 16 (27%) from primary pancreatic (n = 9), gastric (n = 2), urothelial (n = 1), esophageal (n = 1), gallbladder (n = 1), bile duct (n = 1) cancer, and lymphoma (n = 1). The cytology from 2 patients was atypical (1 suspicious for malignancy and 1 considered reactive) and the remaining 42 were benign. Potential complications occurred in 2 of 60 (3%) patients with self-limited fever. Of the 8 of 60 (13%) patients who underwent subsequent surgery, 3 had metastatic pancreatic adenocarcinoma (n = 2) and metastatic small intestinal carcinoid (n = 1) to the peritoneum after negative EUS-FNA cytology. CONCLUSIONS: EUS frequently identifies ascites missed by other imaging studies. EUS-guided paracentesis may identify malignancy in a subset of patients. Negative ascitic fluid cytology from EUS FNA does not exclude possible peritoneal carcinomatosis.

Endoscopic ultrasound-guided fine-needle aspiration of ascites. Publishing Authors By Initials

J DeWitt,J LeBlanc,L McHenry,K McGreevy,S Sherman,J DeWitt,J LeBlanc,L McHenry,K McGreevy,S Sherman,

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Endoscopic ultrasound-guided fine-needle aspiration of ascites. Journal Published:

PUBLICATION TYPE: Journal Article

Journal: Clinical gastroenterology and hepatology : the off

VOLUME: 5

Page Numbers: 609-15

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ISSN: 1542-7714

DAY: 2

MONTH: 03

YEAR: 2007

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LANGUAGE: eng

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AFFILIATION: Department of Gastroenterology and Hepatology, Indiana University Medical Center, Indianapolis, Indiana, USA.

Country: United States

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MEDLINETA: Clin Gastroenterol Hepatol

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