Possibilities of gastrointestinal ultrasonography in detection of pathological processes of distal esophagus and cardio-esophageal zone

Abstract

Introduction Gastrointestinal ultrasonography has existed in the world medical practice more than 35 years ago.The first works on this subject date back to 1978-79 years. Lately ultrasound diagnostics has been unfairly relegated to the background due to development and introduction of ultramodern diagnostic technologies such as computed, magnetic-resonance and positron-emission tomography. But recently ultrasonography as a whole and gastrointestinal ultrasonography in particular are gaining strength in many countries, although they meet some resistance. Along with informative ultrasound techniques of the stomach and intestines, recently ultrasonography of the distal esophagus and the cardioesophageal zone has become widespread. Objectives The purpose of this work is to determine the advantages, value and objectives of in identifying organic and functional pathologyof the distal esophagus and cardio-esophageal zone. Advantages 1. Non-invasiveness and toleratibility by all categories of patients in comparison to endoscopic studies. 2. Absence of radiation in comparison to X-ray and CT. 3. Visualization and evaluation of all layers of the esophagus s wall in contrast to endoscopy. 4. Budget method in comparison with CT and MRT Value 1. Availability for the general population 2. Ability to use as a screening diagnostic method Aim 1. Primary detection of pathological processes of the cardio-esophageal zone 2. Patient s orientation to further examination if it s necessary 3. Patient orientation towards conservative treatment by gastroenterologists, or operative treatment by surgeons. Methods Examined patients were grouped according to the following pathological processes, revealed by ultrasonography: 1. Cardial insufficiency - with hiatal ring s dilatation to 16-18 mm 2. Sliding unfixed hiatal hernia - with a hiatal ring s dilatation over 18 mm, changing during a Valsalva maneuver 3. Sliding fixed hiatal hernia- with hiatal ring s dilatation over 18 mm, not changing during the Valsalva maneuver 4. Distal reflux esophagitis, including erosive and ulcerative 5. Tumors of the distal esophagus and cardioesophageal zone There are certain limitations visualization of the cardioesophageal zone: 1. Hypersthenic constitutional patient type 2. Excessive thickness of subcutaneous fat 3. Increased flatulence in the stomach However, in most cases, ultrasound diagnosis of the pathology of the cardio-esophageal zone is carried out smoothly and very successfully. Conclusion Gastrointestinal ultrasonography is a valuable informative non-invasive, non-radiating method for diagnosing functional and organic diseases of the distal esophagus and cardioesophageal zone, which deserves wide application in world medical diagnostic practice.This technique can be widely used in the screening of reflux disease, inflammatory and oncological pathology of the cardioesophageal zone.