Endoscopic ultrasound (EUS)-guided puncture technique is presently under evaluation. 1 Van Dam J Rice TW Sivak Jr, MV Endoscopic ultrasonography and endoscopically guided needle aspiration for the diagnosis of upper gastrointestinal tract foregut cysts. Am J Gastroenterol. 1992; 87: 762-765 PubMed Google Scholar , 2 Vilmann P Jacobsen GK Henriksen FW Hancke S Endoscopic ultrasonography with guided fine-needle aspiration biopsy in pancreatic disease. Gastrointest Endosc. 1992; 38: 172-173 Abstract Full Text PDF PubMed Scopus (533) Google Scholar , 3 Tio TL Sie LH Tytgat GNJ Endosonography and cytology in diagnosing and staging pancreatic body and tail carcinoma. Preliminary results of endosonographic guided puncture. Dig Dis Sci. 1993; 38: 59-64 Crossref PubMed Scopus (28) Google Scholar , 4 Chang KJ Katz KD Durbin TE et al. Endoscopic ultrasound-guided fine-needle aspiration. Gastrointest Endosc. 1994; 40: 694-699 PubMed Google Scholar , 5 Wiersema MJ Kochman ML Cramer HM Tao LC Wiersema LM Endosonography-guided real-time fine-needle aspiration biopsy. Gastrointest Endosc. 1994; 40: 700-707 PubMed Google Scholar , 6 Wegener M Adamek RJ Wedmann B Pfaffenbach B Endosonographically guided fine-needle aspiration puncture of paraesophagogastric mass lesions: preliminary results. Endoscopy. 1994; 26: 586-591 Crossref PubMed Scopus (65) Google Scholar , 7 Vilmann P Hancke S Henriksen FW Jacobsen GK Endoscopic ultrasonography-guided fine-needle aspiration biopsy of lesions in the upper gastrointestinal tract. Gastrointest Endosc. 1995; 41: 230-235 Abstract Full Text Full Text PDF PubMed Scopus (101) Google Scholar This procedure would enable cytohistologic examination of lesions of the gastrointestinal wall and adjacent organs to be carried out under EUS real-time visualization. A newly developed endoscopic ultrasound transducer was designed for the purpose of performing EUS-guided puncture. The instrument has a linear scanning ultrasound transducer and an independent forceps channel for EUS-guided puncture. We also have recently developed a new set of needles for EUS-guided histologic biopsy. We report here preliminary results of EUS-guided histologic needle biopsy of submucosal lesions and lesions adjacent to the upper gastrointestinal tract using this instrument.

Endoscopic ultrasound-guided pancreatography was performed on a 48-year-old man with a diagnosis of pancreatic stone. A pylorus-preserving pancreaticoduodenectomy had been performed previously on this patient, approximately two years earlier, following the diagnosis of a tumor-forming pancreatitis. Endoscopic retrograde pancreatography and conventional ultrasound-guided percutaneous pancreatography had failed to yield a diagnosis. However, endoscopic ultrasound-guided pancreatography was performed successfully, delineating the pancreatic duct and a filling defect caused by intraductal calculi. Endoscopic ultrasound-guided pancreatography will be a potential alternative in cases when endoscopic retrograde pancreatography has failed or proved non-diagnostic.

A patient with obstructive jaundice was found to have bile duct carcinoma and right hepatic lobe agenesis. The diagnosis was made by computed tomography (CT), cholangiography, and angiography. Right hepatic lobe agenesis is a rare anomaly and has never been previously reported with bile duct carcinoma. CT cholangiography was critical in diagnosing the morphologic anomalies of the bile duct in this case.