The Comparative Study of Endoscopic Ultrasound (EUS) versus Esophagogastroduodenoscopy (EGD) plus Transabdominal Ultrasound (TUS) for Diagnosed Dyspepsia in Elderly Patients

Background: Dyspepsia is common in clinical practice and the etiologies may be from diseases in both the luminal and extraluminal upper GI tract. Esophagogastroduodenoscopy (EGD) provides information on the intraluminal pathology. Whereas endoscopic ultrasound (EUS) that combined endoscopic imaging with US imaging may be an ideal, single-step diagnostic test for detecting, or excluding underlying causes of dyspepsia. Patients and Methods: Patients older than 50 years with uninvestigated dyspepsia were recruited. All patients underwent EUS followed by EGD in the same day. Transabdominal US was performed 1 week before or after the endoscopic examination. Each of these studies was performed by an independent operator blinded to the results of the other examinations. Results: Fifty patients were recruited. The EGD significantly detected more abnormal intraluminal lesions than EUS, 33 vs 23 patients (p = 0.046). TUS insignificantly detected more extra abdominal lesions than EUS, 30 vs 10 patients respectively, (p = 1). EUS detected more pancreaticobiliary tract lesions than TUS, 7 vs 4 patients, even though, it failed to reach statistical significant (p = 0.167). Conclusions: EUS did not provide additional useful information in elderly patients with dyspepsia. EUS should not be considered a routine diagnostic tool in elderly patients unless some suspicious clinical parameters were identified.