Endoscopic ultrasonography in the diagnosis of extraluminal compressions mimicking gastric submucosal tumors.

We evaluated the diagnostic usefulness of endoscopic ultrasonography (EUS) in 19 patients with extragastric compression. In these 19 cases, the causes of the compression were normal organs or structures in 16 cases (splenic artery 7, spleen 5, normal pancreas two, gall-bladder one, colon one) and extraluminal tumors in three cases (two hepatic hemangiomas, one neurogenic tumor of the omentum minor). In 12 of these 19 cases, the site of the submucosal compression was located in the upper part of the stomach. All three tumors were confirmed by other procedures, and in the remaining 16 patients with compression by normal organs or structures, negative follow-up results (mean: 14 months) supported the absence of a true submucosal tumor. EUS was 100% accurate in the differentiation of an extragastric compression from a submucosal tumor, and in the identification of the compressing organ. EUS was also far superior to other procedures, such as ultrasonography and CT. It significantly shortens the diagnostic procedure, especially in patients with compressions by normal extraluminal structures, making other diagnostic modalities unnecessary.