Skip to main content
Log in

Endoscopic diagnosis of submucosal gastric lesions

The results after routine endoscopy

  • Original Articles
  • Published:
Surgical Endoscopy Aims and scope Submit manuscript


The accurate diagnosis of submucosal gastric lesions is difficult. In an attempt to study this problem, the endoscopic records for 8 consecutive years (July 1976–June 1984) were scanned with the help of a computer-based registration of the endoscopic findings. The examinations were identified in which the endoscopic diagnosis indicated the presence of a submucosal tumor. Fifty-four such patients were found in 15,104 routine examinations, giving an incidence of 0.36%. Six patients were lost to follow-up, so the study is based on 48 patients. The most common reason these patients underwent endoscopy was abdominal pain. Five patient groups were identified: (a) nine patients were correctly diagnosed as having gastric wall neoplasia at the initial endoscopy + biopsy; (b) in an additional 13 patients, the suspected gastric wall neoplasia was verified by further nonoperative diagnostic procedures; (c) five patients were found to have benign non-neoplastic gastric disease; (d) five patients had extragastric disease that pressed against the gastric wall; (e) in 14 patients a further work-up indicated that the initial endoscopy was false-positive. These five groups were confirmed by additional diagnostic procedures (including laparotomy)and a follow-up time of more than 5 yearsor autopsy. Two patients refused further examinations and died shortly afterward. No autopsies were performed. Based on our data, it would seem that in the vast majority of patients the suspicion of a submucosal gastric lesion at endoscopy indicates the presence of a serious condition.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others


  1. Asaki S, Ishii N, Nishimura T, Ohara S, Yamaguchi N, Tamura T (1986) New bioptic method for submucosal tumour of the gastrointestinal tract. Tohoku J Exp Med 150: 401–406

    Google Scholar 

  2. Bengtsson T (1989) Population changes 2: mobility between municipalities (in Swedish). Central Bureau of Statistics for Sweden, Stockholm

    Google Scholar 

  3. Blackstone MO (1984) Endoscopic interpretation. Raven Press, New York, pp 158–169

    Google Scholar 

  4. Cotton PB (1973) Fibre-optic endoscopy and the barium meal — results and implications. Br Med J 2: 161–165

    Google Scholar 

  5. Crosta C, Meroni E, Alloni R, Botti F, Carrara A, Taschieri AM (1987) Gastric submucosal neoplasms: new diagnostic and therapeutic procedures. Ital J Surg Sci 17: 131–134

    Google Scholar 

  6. Herlinger H, Glanville JN, Kreel L (1977) An evaluation of the double contrast barium meal against endoscopy. Clin Radiol 28: 307–314

    Google Scholar 

  7. Iishi H, Yamamoto R, Tatsuta M, Okuda S (1986) Evaluation of fine-needle aspiration biopsy under direct vision gastrofiberscopy in diagnosis of diffusely infiltrative carcinoma of the stomach. Cancer 57: 1365–1369

    Google Scholar 

  8. Kaneko E, Kumagai J, Honda N, Nakamura S, Kino I (1983) Evaluation of the new giant-biopsy forceps in the diagnosis of mucosal and submucosal gastric lesions. Endoscopy 15: 322–326

    Google Scholar 

  9. Lange P, Kock K, Laustsen J, Arffmann E, Teglbjaerg PS (1987) Endoscopic fine-needle aspiration cytology of the stomach. Endoscopy 19: 72–73

    Google Scholar 

  10. Mountford RS, Brown P, Salmon PR, Alvarenga C, Neumann CS, Read AE (1980) Gastric cancer detection in gastric ulcer disease. Gut 21: 9–17

    Google Scholar 

  11. Murata Y, Yoshida M, Akimoto S, Ide H, Suzuki S, Hanyu F (1988) Evaluation of endoscopic ultrasonography for the diagnosis of submucosal tumours of the oesophagus. Surg Endosc 2: 51–58

    Google Scholar 

  12. Siegel M, Barkin J, Rogers S, et al. (1983) Gastric biopsy: a comparison of biopsy forceps. Gastrointest Endosc 29: 35–36

    Google Scholar 

  13. Silverstein FE, Tytgat GNJ (1987) Atlas of gastrointestinal endoscopy, vol 6. Gower Medical, London New York, p 18

    Google Scholar 

  14. Strohm WD, Classen M (1986) Benign lesions of the upper GI tract by means of endoscopic ultrasonography. Scand J Gastroenterol 21 [Suppl 123]: 41–46

    Google Scholar 

  15. Tio TL (1988) Endosonography in gastroenterology. Springer, Berlin Heidelberg New York, pp 104–116

    Google Scholar 

Download references

Author information

Authors and Affiliations


Rights and permissions

Reprints and permissions

About this article

Cite this article

Hedenbro, J.L., Ekelund, M. & Wetterberg, P. Endoscopic diagnosis of submucosal gastric lesions. Surg Endosc 5, 20–23 (1991).

Download citation

  • Issue Date:

  • DOI:

Key words