ENDOSCOPIC ULTRASOUND (EUS)

WHAT IS ENDOSCOPIC ULTRASOUND?

Endoscopic ultrasound is a procedure where an endoscope is inserted into the gastrointestinal tract to obtain targeted and detailed video and ultrasound images used in the diagnosis of various conditions.

EUS IS USEFUL FOR:

  • Diagnosis, biopsy and staging of oesophageal, gastric, duodenal and pancreatic cancer
  • Diagnosis, monitoring and aspiration of pancreatic cysts and other lesions
  • Diagnosis, biopsy and monitoring of oesophageal, gastric and duodenal submucosal and extrinsic masses
  • Diagnosis of biliary disease, such as gallstones in the bile duct
  • Biopsy of mediastinal masses and lymph nodes

WHAT IS AN ENDOSCOPE?

An endoscope is a thin, tube-like instrument that has a light and a tiny video camera for viewing. In endoscopic ultrasound employs a ultrasound probe at the end of the endoscope is used to obtain an image of the oesophagus, stomach or internal organs.

The endoscope is inserted into the body, usually through the mouth, similar to gastroscopy. This allows various instruments to be used for drainage, biopsy or medication delivery.

WHY IS ENDOSCOPIC ULTRASOUND PERFORMED?

EUS is used to assist the diagnosis and management of:

  • some causes of abdominal pain
  • abnormalities seen on gastroscopy such as submucosal masses
  • determining the extent of diseases in your digestive tract, and
  • evaluating findings from imaging tests such as CT scans or MRI

HOW IS ENDOSCOPIC ULTRASOUND USED?

There are two medical applications for Endoscopic Ultrasound these are:

  • Diagnostic Endoscopic ultrasound
  • Guided Endoscopic ultrasound

ABOUT DIAGNOSTIC ENDOSCOPIC ULTRASOUND

Endoscopic ultrasound is applied as a non surgical diagnostic or imaging technique for the assessment of various conditions. Generally EUS can assist in the understanding of:

  • Assess abnormalities or tumors in various organs
  • Determine a cancer’s progression (stage or metastasis)
  • Review nodules (bumps) in the intestinal wall
  • Evaluate abnormal findings from imaging tests

WHAT CONDITIONS ARE DIAGNOSED EUS?

Endoscopic ultrasound (EUS) is employed in the diagnosis or investigation of the following conditions:

  • oesophageal tumors
  • gastric tumours
  • pancreatitis and pancreatic cysts and masses
  • biliary and pancreatic duct disease
  • disorders of the gallbladder and liver.
  • mediastinal masses and lymphadenopathy.
  • lower rectum and anal canal muscle disorders

ABOUT THE PROCEDURE

Endoscopy and ultrasound are used to make an image of the upper GI tract and when a biopsy is needed.

The endoscope is inserted through the mouth and into the esophagus, stomach, and first part of the small intestine, similar to gastroscopy. An ultrasound probe at the end of the endoscope is used to make images of  internal tissues or organs.

This procedure is also called endosonography. Guided by the sonogram, the doctor can obtain a small amount tissue using a thin, hollow needle. A pathologist views the tissue under a microscope to look for cancer cells.

Guided Endoscopic ultrasound BIOPSY

What is a Guided EUS Biopsy?

When combined with a procedure called fine-needle aspiration, EUS allows Dr Dixson to sample (biopsy) fluid and tissue from your abdomen or chest for analysis.  EUS techniques are also used to guide certain treatments such as:

  • Draining pseudocysts.
  • Guided drainage of other collections of fluid in the abdomen
  • Precise targeting and delivery of medication into the pancreas, liver and other organs

WHAT ARE THE BENEFITS OF A GUIDED EUS  BIOPSY?

EUS with fine-needle aspiration allows a sample to be obtained of difficult to reach masses with greater safety and less chance of spread of disease. The procedure is done as a “day only” patient under sedation so there is less discomfort.

ENDOSCOPIC ULTRASOUND RISKS

EUS is performed on an outpatient basis and is well-tolerated by most people.

The most serious risk with any endoscopy is perforation of the gastrointestinal tract (stomach or oesophagus in the case of upper EUS). Fortunately this is extremely rare.

Other risks include bleeding and infection if a biopsy is performed, and pancreatitis if biopsy of the pancreas is biopsied.

The most common side-effects are short-term abdominal pain due to the air used to inflate the stomach during the procedure and a mild sore throat from the endoscope.

RECOVERY AFTER EUS

After sedation, the doctor inserts an endoscope into the person's mouth or rectum. The doctor will observe the inside of the intestinal tract on a TV monitor and the ultrasound image on another monitor.

Additionally the sound wave testing may be used to locate and help take biopsies (small piece of tissue to examine by microscope). The entire procedure usually takes 30 to 90 minutes and the patient usually can go home the same day of the procedure.

ENDOSCOPIC ULTRASOUND RISKS

Risks EUS is performed on an outpatient basis and is well-tolerated by most people.