smaller doses given more frequently)
Endoscopic Ultrasonography of Subepithelial Lesions Lesion Layer Pattern Stain Miscellaneous Carcinoid Duplication cyst or varices 2,3 Cyst: 2,3,4,5 Varices: 3 (can course through all layers) 2,3,4 3 3,4 3,4 4 (usually) 2,3 (rare) 4 (usually) 2,3 (rare) Hypoechoic or isoechoic Anechoic NA NA Hypoechoic (usually) Hyperechoic Hypoechoic Hypoechoic (usually) Hypoechoic NA NA +S100 +Vimentin +Desmin, +SMA, CD117 +CD117 (c-Kit) +PDGFRa NA Duplication cyst: Doppler negative Varices: Doppler positive Central umbilication Pillow sign NA NA NA Pancreatic rest Lipoma Schwannoma Glomus tumor Leiomyoma GIST Hypoechoic NA Abbreviations: GIST, gastrointestinal stromal tumor

[20] Patients should contact their GP or bariatric team promptly if they experience any of the following: New or worsening tingling, numbness, or weakness in the limbs Difficulty with balance, coordination, or memory Unexplained fatigue, breathlessness, or palpitations A sore or swollen tongue, or persistent mouth ulcers Any concern that they have missed supplementation for a prolonged period Symptoms that suggest anaemia, such as pallor or dizziness New or worsening neurological symptoms such as paraesthesia, gait disturbance, or cognitive change warrant same-day assessment
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