EUS (Endoscopic Ultrasound)
Endoscopic ultrasonography (EUS) allows your doctor to examine the walls of your upper and lower gastrointestinal tract. The upper tract consists of the esophagus, stomach and duodenum; the lower tract includes your colon and rectum. EUS is also used to study other organs that are near the gastrointestinal tract, including the lungs, liver, gall bladder and pancreas.
EUS provides your doctor with more information than other tests by providing detailed images of your digestive tract. Your doctor can use EUS to diagnose certain conditions that may cause abdominal pain or abnormal weight loss.
EUS is also used to evaluate known abnormalities, including lumps or lesions, which were detected at a prior endoscopy or were seen on x-ray tests, such as a computed tomography (CT) scan. EUS provides a detailed image of the lump or lesion, which can help your doctor determine its origin and help treatment decisions. EUS can be used to diagnose diseases of the pancreas, bile duct and gallbladder when other tests are inconclusive or conflicting.
EUS is generally safe when performed at a center with an experienced and expert health care team. Your doctor will discuss with you the risk of complications from EUS . These risks are most commonly associated with fine-needle aspiration.
Risks may include:
– Bleeding
– Infection
– Tearing (perforation) of the intestinal wall or throat
– Pancreatitis, if fine-needle aspiration of the pancreas is done
- Your endoscopist will use a thin, flexible tube called an endoscope that has a built-in miniature ultrasound probe. Your doctor will pass the endoscope through your mouth or anus to the area to be examined. Your doctor then will use the ultrasound to use sound waves to create visual images of the digestive tract.
There are many different tests which can be used to evaluate the pancreas. CT scans and MRI are types on non-invasive tests which allow for detailed imaging of the pancreas and the surrounding structures in the abdominal cavity. CT scans expose the patient to some amount of radiation. Furthermore, some patients are unable to receive IV contrast for their CT scans (due to allergies or kidney problems), and thus the quality of the pictures will be sub-optimal. A special kind of MRI called an MRCP can give high-quality pictures of the pancreas, the pancreas duct, and the bile ducts. However, some patients who are claustrophobic may decide against having an MRI performed.
As discussed, EUS allows the physician to get in very close proximity to the pancreas, which results in very detailed imaging of the organ. The endoscopist can often times visualize details of the pancreas that cannot be seen with either CT or MRCP. Furthermore, there is no exposure to radiation and no need for contrast to be given. In addition, because the EUS scope has a video camera on it, endoscopic evaluation of the esophagus, stomach, and first part of the small intestine can also be evaluated at the time of the EUS. This is important for some patients who are having a work-up for abdominal pain as it allows for a complete examination of the upper GI system.
The biggest advantage of EUS is that, unlike with CT or MRCP, pancreatic biopsies can be safely and easily obtained at the time of the exam.
After the EUS procedure, the patient remains in the recovery room until the sedative medicine has worn off. The patient should not drive a vehicle after the procedure.
Patients may feel full or the need to pass gas after the procedure. Also, the patient may have changes in bowel habits, such as soft stool. The healthcare team provides instructions on eating and drinking after an EUS.
Call your doctor immediately or go to an emergency room if you experience any of the following signs or symptoms:
– Fever
– Chest pain
– Shortness of breath
– Black or very dark-colored stool
– Severe or persistent abdominal pain