Endoscopic Ultrasound (EUS)

Endoscopic Ultrasound (EUS) is a test that combines upper endoscopy (EGD) and ultrasound. EUS obtains images and information about the digestive tract and the surrounding tissues and organs.

Equipment
EUS uses a flexible endoscope with a small ultrasound transducer installed on the tip of the scope. Because the transducer is placed at the tip of the scope it allows the endoscopist to get very close to the area of interest, which allows for more accurate imaging.

REASON FOR THE EXAM
EUS provides more detailed images of the digestive tract. Since it is a fairly new diagnostic tool, its uses are still being developed but is presently being utilized for:

  • Diagnosis and staging of cancers of the esophagus, stomach, pancreas and rectum
  • Diagnosis and staging lung cancer
  • Evaluating and studying abnormalities in the pancreas, liver, gall bladder and bile duct
  • Evaluating and studying "submucosal lesions" like nodules or bumps that are covered by normal appearing lining of the intestinal tract

EUS can provide information on the staging of cancer such as the depth of penetration of a mass or tumor. This is very important for accurate diagnosis and treatment plan.

PREPARATION
The preparation for EUS is nothing to eat or drink after midnight. Clear liquids are allowed up to six (6) hours before appointment if scheduled late in the day. Additional preparation is necessary for LOWER EUS procedures, two (2) fleet enemas; first enema two (2) hours before and the second enema one (1) hour before the scheduled appointment.

You will be given detailed written instructions at the time your procedure is scheduled. If you have any questions after reading your instructions please call the office.

PROCEDURE
EUS is usually performed on an outpatient basis. The upper EUS is done under anesthesia and the throat is often anesthetized by a spray or liquid. Intravenous sedation may be given for lower EUS to relax the patient.

Once sedated, the endoscope will be inserted and the procedure started. The physician will observe your intestinal tract on a TV monitor and ultrasound images on another monitor. The procedure will take between 30 to 90 minutes depending on the complexity and if a fine needle aspiration (FNA) is done.

RESULTS
After the procedure, the patient will go to the recovery area and the physician will discuss with the patient and (if patient allows) the person with them, the findings of the procedure when they wake up. If tissue sample is obtained during the procedure the results may take seven (7) to fourteen (14) days.

BENEFITS
EUS allows the physician to microscopically examine the tissue or organs. It shows the inner surface that may look normal from the outside. This is critical to accurately diagnose the full nature of the abnormality and plan for the specific treatment.

COMPLICATIONS
A temporary mild sore throat may occur for a day or more. Bleeding from the biopsy site and pancreatitis may also occur. These may be minimal and may not require any follow up. Common potential risk for anesthesia may also be observed. One major but uncommon complication is perforation. This complication may require surgical intervention. The physician will explain the risks and benefits of the procedure at the time of the preliminary consultation.

SUMMARY
EUS is a great diagnostic procedure. It can accurately diagnose and provide optimum care for otherwise inconclusive diagnoses.