Atlas of Endoscopic Ultrasonography Companion DVD-ROM This book is accompanied by a companion DVD with: • A database of videos showing procedures described in the book. • A search feature. • All videos are referenced in the text at the end of each chapter. All fi gures from the book are available for downloading at: www.wiley.com/go/gress/ultrasonography. Note on access: Wiley publishes its books in a variety of electronic formats and by print-on-demand. Not all content that is available in standard print versions of this book may appear or be packaged in all book formats. If you have purchased a version of this book that did not include media that is referenced by or accompanies a standard print version, you may request this media by visiting: http://booksupport.wiley.com. For more information about Wiley products, visit us at: www.wiley.com. We dedicate this to our families whose support and love allowed us to create this atlas. Atlas of Endoscopic Ultrasonography EDITED BY Frank G. Gress MD, FACP, FACG Professor of Medicine Chief, Division of Gastroenterology and Hepatology State University of New York Downstate Medical Center Brooklyn, NY, USA Thomas J. Savides MD Professor of Clinical Medicine Division of Gastroenterology University of California, San Diego La Jolla, CA, USA Brenna Casey Bounds MD, FASGE Director of Endoscopic Training Massachusetts General Hospital Harvard Medical School Boston, MA, USA John C. Deutsch MD Essentia Health Care Systems Duluth, MN, USA A John Wiley & Sons, Ltd., Publication This edition fi rst published 2012 © 2012 by Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. Blackwell’s publishing program has been merged with Wiley’s global Scientifi c, Technical and Medical business to form Wiley-Blackwell. 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Gastrointestinal system–Ultrasonic imaging–Atlases. I. Gress, Frank G. [DNLM: 1. Endosonography–Atlases. 2. Digestive System–ultrasonography– Atlases. 3. Digestive System Diseases–ultrasonography–Atlases. WN 17] RC804.E59A85 2011 616.07'543–dc23 2011014520 A catalogue record for this book is available from the British Library. This book is published in the following electronic formats: ePDF 9781444346275; Wiley Online Library 9781444346305; ePub 9781444346282; Mobi 9781444346299 Set in 9/12pt Meridien by Toppan Best-set Premedia Limited 01 2012 v List of Contributors, vii Preface, x Part 1 Normal EUS Anatomy, 1 1 Normal Human Anatomy, 3 John C. Deutsch 2 Esophagus: Radial and Linear, 10 James L. Wise & John C. Deutsch 3 Normal Mediastinal Anatomy by EUS and EBUS, 14 Silvio Wanderley de Melo Jr. & Michael B. Wallace 4 Stomach: Radial and Linear, 18 Joo Ha Hwang 5 Bile Duct: Radial and Linear, 21 Kapil Gupta 6 EUS of the Normal Pancreas, 24 Richard A. Erickson & James T. Sing Jr. 7 Liver, Spleen, and Kidneys: Radial and Linear, 29 Nalini M. Guda & Marc F. Catalano 8 Anatomy of the Anorectum: Radial and Linear, 32 Christoph F. Dietrich Part 2 Upper and Lower GI EUS, 35 9 Esophageal Cancer, 37 Syed M. Abbas Fehmi 10 Esophageal Motility Disorders, 44 Thuy Anh Le & Ravinder K. Mittal 11 Malignant Mediastinal Lesions, 54 M. Babitha Reddy, David H. Robbins, & Mohamad A. Eloubeidi 12 Benign Mediastinal Lesions, 57 M. Babitha Reddy, David H. Robbins, & Mohamad A. Eloubeidi 13 Gastric Cancer, 59 Douglas O. Faigel & Sarah A. Rodriguez 14 Gastric and Esophageal Subepithelial Masses, 64 David J. Owens & Andrew J. Bain 15 Anorectal Neoplasia, 70 Manoop S. Bhutani & Everson L. A. Artifon 16 Anal Sphincter Disease: Fecal Incontinence and Fistulas, 75 Raymond S. Tang & Thomas J. Savides 17 Other Pelvic Pathology, 81 Everson L. A. Artifon, Lucio G. B. Rossini, & Carlos K. Furuya Jr. 18 Vascular Anomalies and Abnormalities, 88 John C. Deutsch Part 3 Pancreatico-biliary, 93 19 Duodenal and Ampullary Neoplasia, 95 Brenna Casey Bounds 20 Biliary Tract Pathology, 97 Brenna Casey Bounds 21 Gallbladder Pathology, 100 Sam Yoselevitz & Ann Marie Joyce 22 Pancreatic Adenocarcinoma, 103 Douglas G. Adler 23 Pancreatic Malignancy (Non-adenocarcinoma), 107 Michael J. Levy & Suresh T. Chari 24 Autoimmune Pancreatitis, 112 Michael J. Levy & Suresh T. Chari 25 Pancreatic Cystic Lesions: The Role of EUS, 116 William R. Brugge 26 Intraductal Papillary Mucinous Neoplasms: The Role of EUS, 120 William R. Brugge 27 Chronic Pancreatitis, 124 David G. Forcione Contents Contents vi 28 Liver Pathology, 129 Indraneel Chakrabarty & Ann Marie Joyce Part 4 How to Section, 133 29 How to Interpret EUS-FNA Cytology, 135 Cynthia Behling 30 How to do Mediastinal FNA, 144 Sammy Ho 31 How to do Pancreatic Mass FNA, 148 Michael D. Harris & Jonathan M. Buscaglia 32 How to do Pancreatic Mass Tru-cut Biopsy, 153 Michael J. Levy & Maurits J. Wiersema 33 How to do Pancreatic Cyst FNA, 159 Aman Ali & William R. Brugge 34 How to do Pancreatic Pseudocyst Drainage, 162 Shyam Varadarajulu & Vinay Dhir 35 How to do Pancreatic Cyst Ablation, 167 John DeWitt 36 How to do Celiac Plexus Block, 172 Adam J. Goodman & Frank G. Gress 37 How to Place Fiducials for Radiation Therapy, 175 Satish Nagula & Christopher J. DiMaio 38 How to Inject Chemotherapeutic Agents, 178 V. Raman Muthusamy & Kenneth J. Chang 39 How to do EUS-guided Biliary Drainage, 181 Jennifer Maranki & Michel Kahaleh 40 How to do EUS-guided Pelvic Abscess Drainage, 186 Shyam Varadarajulu & Sandeep Lakhtakia 41 How to do Doppler Probe EUS for Bleeding, 190 Richard C. K. Wong Index, 199 Companion DVD-ROM This book is accompanied by a companion DVD with: • A database of videos showing procedures described in the book. • A search feature. • All videos are referenced in the text at the end of each chapter. All fi gures from the book are available for downloading at: www.wiley.com/go/gress/ultrasonography. Note on access: Wiley publishes its books in a variety of electronic formats and by print-on-demand. Not all content that is available in standard print versions of this book may appear or be packaged in all book formats. If you have purchased a version of this book that did not include media that is referenced by or accompanies a standard print version, you may request this media by visiting: http://booksupport.wiley.com. For more information about Wiley products, visit us at: www.wiley.com. vii Douglas G. Adler MD, FACG, AGAF, FASGE Associate Professor of Medicine Director of Therapeutic Endoscopy Gastroenterology and Hepatology University of Utah School of Medicine Salt Lake City, UT, USA Aman Ali MD Gastroenterology Fellow Massachusetts General Hospital Boston, MA, USA Everson L. A. Artifon MD, PhD, FASGE Associate Professor of Surgery University of S ã o Paulo, S ã o Paulo, Brazil Director, Pancreatic - biliary Endoscopy Ana Costa Hospital, Santos, Brazil Andrew J. Bain MD Clinical Instructor Division of Gastroenterology University of California, San Diego La Jolla, CA, USA Cynthia Behling MD, PhD Pacifi c Rim Pathology Group Sharp Memorial Hospital Voluntary Associate Professor of Pathology University of California, San Diego San Diego, CA, USA Manoop S. Bhutani MD, FASGE, FACG, FACP, AGAF Professor of Medicine, Experimental Diagnostic Imaging and Biomedical Engineering Director, Endoscopic Research and Development University of Texas MD Anderson Cancer Center Houston, TX, USA Brenna Casey Bounds MD, FASGE Director of Endoscopic Training Massachusetts General Hospital Harvard Medical School Boston, MA, USA List of Contributors William R. Brugge MD Director, Gastrointestinal Endoscopy Massachusetts General Hospital Professor of Medicine Harvard Medical School Boston, MA, USA Jonathan M. Buscaglia MD Director of Advanced Endoscopy Assistant Professor of Medicine Stony Brook University Medical Center State University of New York Stony Brook, NY, USA Marc F. Catalano MD Clinical Associate Professor of Medicine Medical College of Wisconsin Pancreatobiliary Services St. Luke ’ s Medical Center Milwaukee, WI, USA Indraneel Chakrabarty MD, MA Clinical Associate of Medicine Tufts University School of Medicine Division of Gastroenterology Lahey Clinic Medical Center Burlington, MA, USA Kenneth J. Chang MD Professor of Clinical Medicine Division Chief, Gastroenterology University of California, Irvine Irvine, CA, USA Suresh T. Chari MD Professor of Medicine Division of Gastroenterology Mayo Clinic Rochester, MN, USA Silvio Wanderley de Melo Jr. MD Assistant Professor Division of Gastroenterology and Hepatology University of South Alabama Mobile, AL, USA John C. Deutsch MD Essentia Health Care Systems Duluth, MN, USA John DeWitt MD, FACG, FACP, FASGE Associate Professor of Medicine Co - director, Endoscopic Ultrasound Clinical Program Division of Gastroenterology and Hepatology Indiana University Medical Center Indianapolis, IN, USA Vinay Dhir MD, DNB Director Clinical Research and Chief of Endosonography Institute of Advanced Endoscopy Mumbai, India Christoph F. Dietrich MD Professor, Second Department of Internal Medicine Caritas - Krankenhaus Bad Mergentheim, Germany Christopher J. DiMaio MD Associate Director, Advanced Endoscopy Fellowship Gastroenterology and Nutrition Service Memorial Sloan - Kettering Cancer Center New York, NY, USA Mohamad A. Eloubeidi MD, MHS, FASGE, FACP, FACG, AGAF Professor of Medicine American University of Beirut School of Medicine Beirut, Lebanon Richard A. Erickson MD, FACP, FACG, AGAF Director, Division of Gastroenterology Scott and White Clinic and Hospital Professor of Medicine Texas A & M Health Science Center Temple, TX, USA Contributors viii Douglas O. Faigel MD, FACG, FASGE, AGAF Professor of Medicine Division of Gastroenterology and Hepatology Mayo Clinic College of Medicine Scottsdale, AZ, USA Syed M. Abbas Fehmi MD, MSc Clinical Assistant Professor of Medicine Division of Gastroenterology Department of Medicine University of California, San Diego La Jolla, CA, USA David G. Forcione MD Associate Director of Interventional Endoscopy Massachusetts General Hospital Harvard Medical School Boston, MA, USA Carlos K. Furuya Jr. MD, MSc Assistant Professor of Medicine University of S ã o Paulo School of Medicine S ã o Paulo, Brazil Adam J. Goodman MD Assistant Professor of Medicine Division of Gastroenterology and Hepatology State University of New York Downstate Medical Center Brooklyn, NY, USA Frank G. Gress MD, FACP, FACG Professor of Medicine Chief, Division of Gastroenterology and Hepatology State University of New York Downstate Medical Center Brooklyn, NY, USA Nalini M. Guda MD, FASGE Clinical Associate Professor of Medicine University of Wisconsin, School of Medicine and Public Health Pancreatobiliary Services St. Luke ’ s Medical Center Milwaukee, WI, USA Kapil Gupta MD, MPH Associate Director, Pancreatic and Biliary Diseases Interventional Endoscopy Division of Gastroenterology Cedars - Sinai Medical Center Los Angeles, CA, USA Michael D. Harris MD Division of Gastroenterology and Hepatology Department of Medicine State University of New York at Stony Brook Stony Brook University Medical Center Stony Brook, NY, USA Sammy Ho MD Assistant Professor of Medicine Director of Pancreaticobiliary Services and Endoscopic Ultrasound Division of Gastroenterology Montefi ore Medical Center/AECOM Bronx, NY, USA Joo Ha Hwang MD, PhD Associate Professor of Medicine Division of Gastroenterology Department of Medicine University of Washington Seattle, WA, USA Ann Marie Joyce MD Assistant Professor of Medicine Tufts University School of Medicine Director of Endoscopy Lahey Clinic Medical Center Burlington, MA, USA Michel Kahaleh MD, FACG, FASGE Associate Professor of Medicine Director Pancreatico - biliary Services Division of Gastroenterology and Hepatology University of Virginia Health System Charlottesville, VA, USA Sandeep Lakhtakia MD, MNAMS, DM Consultant Asian Institute of Gastroenterology Hyderabad, India Thuy Anh Le MD Gastroenterology Fellow Division of Gastroenterology University of California, San Diego La Jolla, CA, USA Michael J. Levy MD Consultant Division of Gastroenterology and Hepatology Mayo Clinic Rochester, MN, USA Jennifer Maranki MD Clinical Instructor Division of Gastroenterology and Hepatology University of Virginia Health System Charlottesville, VA, USA Ravinder K. Mittal MD Professor of Medicine Division of Gastroenterology University of California, San Diego La Jolla, CA, USA V. Raman Muthusamy MD, FACG, FASGE Director, Gastroenterology Fellowship Program Health Sciences Associate Clinical Professor of Medicine Division of Gastroenterology Department of Medicine University of California, Irvine Irvine, CA, USA Satish Nagula MD Director of Endoscopy Assistant Professor of Medicine Division of Gastroenterology and Hepatology State University of New York Stony Brook School of Medicine Stony Brook, NY, USA David J. Owens MD Clinical Instructor Division of Gastroenterology University of California, San Diego La Jolla, CA, USA M. Babitha Reddy DO, MPH Gastroenterology Fellow Lenox Hill Hospital New York, NY, USA David H. Robbins MD, MSc Associate Director Center for Advanced Therapeutic Endoscopy Lenox Hill Hospital New York, NY, USA Sarah A. Rodriguez MD Assistant Professor of Medicine Oregon Health and Science University Portland, OR, USA Lucio G. B. Rossini MD Assistant Professor Santa Casa of S ã o Paulo School of Medicine Coordinator, Brazilian – French Center of EUS Research S ã o Paulo, Brazil Thomas J. Savides MD Professor of Clinical Medicine Division of Gastroenterology University of California, San Diego La Jolla, CA, USA James T. Sing Jr. DO, FACG, AGAF Assistant Professor of Medicine Texas A & M University Health Science Center Director, Endoscopy Department of Medicine Scott and White Clinic and Hospital Texas A & M University Health Science Center Temple, TX, USA