The role of endoscopic ultrasonography in diagnosis of benign lesions of the upper GI tract.

The contribution of endoscopic ultrasonography (EUS) in the diagnosis of benign lesions of the upper gastrointestinal (UGI) tract was studied in 46 patients with polypoid lesions which were not thought to have invaded adjacent tissues or organs. Precise visualization of the five layers of the UGI tract was possible with EUS. The site of origin of the tumour was also determined. The diameter of the hypochoic lesions ranged between 1-4 cm, with well-defined margins, and were demarcated precisely from adjacent tissues. Lesions included: (1) leiomyoma of the esophagus, stomach, duodenum (n = 7); (2) ectopic pancreatic tissues (n = 3); (3) polyp of the esophagus, stomach or duodenum (n = 12); (4) hypertrophic gastric folds (n = 19); (5) extra gastric compression (n = 5). Patients from groups 1, 2 and 3 had the diagnosis confirmed and staged surgically. It was possible to differentiate between polypoid lesions of the UGI tract and extra gastric compression. The sensitivity of EUS in the diagnosis of benign tumours was 92%.

Cisapride, metoclopramide, and ranitidine in the treatment of severe nonulcer dyspepsia.

Cisapride, a prokinetic drug with a novel mechanism of action, was compared with another prokinetic drug, metoclopramide, and an H2-blocker, ranitidine, in the treatment of nonulcer dyspepsia. In a double-blind study, 60 patients with severe dyspeptic symptoms received cisapride 5 mg TID, metoclopramide 10 mg TID, or ranitidine 150 mg BID for 8 weeks. Symptoms were evaluated during treatment and 4 weeks after the end of therapy. All three drugs effectively controlled the symptoms of chronic functional upper gastrointestinal tract disorders. The prokinetic drugs, particularly cisapride, were significantly better than ranitidine in controlling symptoms, especially reflux symptoms. All three drugs were generally well tolerated; cisapride in particular was associated with fewer adverse effects.