Endoscopic Ultrasound (EUS)
A High Tech Combination
Endoscopic Ultrasound (EUS) is a relatively new procedure that combines traditional endoscopy with sophisticated ultrasound, to improve our ability to diagnose and treat diseases of the digestive system.
Endoscopy uses a flexible lighted tube which is passed into the gastrointestinal tract through either the mouth or anus to visualized the inside lining of the digestive organs.
Ultrasound uses high frequency sound waves to make cross-sectional pictures of internal organs. Usually this is done by placing ultrasound probes against the skin to visualized internal organs. However, because some digestive organs are located very deep to the skin, it is often difficult to use standard ultrasound methods to adequately view these organs.
Endoscopic Ultrasound places a very sensitive ultrasound probe on the tip of an endoscope. Passing the ultrasound endoscope into the digestive tract allows the ultrasound probe to be placed very close to many internal organs that can be visualized through the digestive tract. Utilizing endoscope ultrasound, physicians can now see beyond the inside surface of the digestive tract in more detail than ever before and collect highly accurate images of organs that lie next to the digestive tract such as the heart, lungs, liver, spleen, pancreas, gallbladder, bile duct and prostate gland.
Using Endoscopic Ultrasound to Direct Needle Biopsy and Injection
Endoscopic ultrasound can be used to provide a "tissue diagnosis" of tumors in and around the digestive tract. This technique is called fine needle aspiration (FNA). Using a specially designed endoscopic ultrasound endoscope, a long, thin needle can be precisely guided by ultrasound through the wall of the digestive tract into tumors, lymph nodes and abdomal fluid collections in and around the digestive tract. The few cells obtained with this needle are place on a microscope slide. The slide is immediately examined by a pathologist to determine whether any abnormal cells are present.
The needle passed through an ultrasound endoscope can also be used to inject drugs into tissues or tumors. This procedure is called endoscopic ultrasound guided fine needle injection (FNI).
Preparing for your Endoscopic Ultrasound Test
Endoscopic ultrasound examinations are generally outpatient procedures and can be performed in the upper or lower gastrointestinal tract. Your doctor will be explaining which type of examination you are to have and the preparation you will need before the test.
Upper Gastrointestinal Endoscopic Ultrasound usually just involves nothing to eat or drink after dinner the night before the examination.
Lower Gastrointestinal Endoscopic Ultrasound usually requires some type of bowel cleansing method to clear your lower bowel. Your doctor/nurse will discuss the appropriate preparation with you before your examination.
How long will the test last?
Since a detailed examination of many internal organs is often being preformed, an endoscopic ultrasound examination can take from 30-minutes to two hours. Extra time may be required if fine needle aspirations or injections are performed. You will be given a relaxing medication by vein to make you comfortable throughout the examination.
You will be required to stay for observation in our recovery room for 30 to 60-minutes after your examination to be sure the relaxing medication is wearing off normally.
I'm taking medication, what should I do?
Your doctor or nurse should discuss what to do about your medications.
You must leave with an adult after your test
When you have an endoscopic ultrasound examination, you'll usually receive relaxing medication by vein for your comfort. Since the effects of this relaxing medication can last for a number of hours, you and your driver should plan on being at Scott & White for several hours. It is Scott & White's policy that an adult must accompany you after your procedure as you cannot drive yourself home.
Your procedure will need to be rescheduled if you have not made arrangements to be taken home by another adult. You should not operate any hazardous equipment until the day after your test.
What are the risks of having an Endoscopic Ultrasound?
Every test has some risks associated with it and it is important that you are informed of these complications, even if they are quite unusual and rarely occur.
There is a chance that you may have a mild sore throat for a day or two after the test or that you may experience some mild bruising or inflammation at the site of your intravenous line. Very rarely, people can have an unexpected reaction to the medication given to relax them for endoscopy examinations. These reactions can be serious such as slowed breathing, very low blood pressure or having abnormal heart beats. Your blood pressure, heart beat and the amount of oxygen in your blood will be monitored throughout your examination to watch for these problems. You may also receive supplemental oxygen if needed during your test.
With endoscopic ultrasound there is a risk of pancreatitis which is inflammation of the pancreas if the pancreas is aspirated. Other rare but serious complications can occur such as bowel perforation (tear or puncture of the digestive lining), bleeding, infection, and heart or lung problems. These rare, unlikely events could require a surgery or hospitalization.
