Endoscopic Ultrasound (EUS)

What is an Endoscopic Ultrasound?

Endoscopic ultrasound (EUS) is a procedure that allows a physician to examine the linings and walls of the esophagus, stomach, duodenum (first part of small intestine), rectum, and lung. It also can examine organs near the gastrointestinal tracts, such as the lung, liver, gallbladder, and pancreas.

The procedure is performed by a physician using a thin flexible tube with a camera and light source called an endoscope, with a miniature ultrasound attached to it. The physician will insert this device through the mouth or anus to examine the necessary organs. The ultrasound probe will generate sound waves to create visual images of the organs being examined.

Why is an Endoscopic Ultrasound Done?

EUS is performed to evaluate the following conditions:

• ‘Bumps’ or lesions in the walls of the esophagus, stomach, duodenum, rectum or colon
• Pancreatic diseases such as chronic pancreatitis
• Cysts or tumors of the pancreas
• Lymph nodes by the lungs, esophagus, stomach, duodenum, rectum or colon
• Abnormalities of the gallbladder or bile ducts such as gallstones
• Esophageal cancer
• Pancreatic cancer
• Rectal cancer
• Lung cancer

EUS can be particularly helpful in the evaluation of certain gastrointestinal and lung cancers as it can help determine the stage of the tumor. It does this by assessing the cancer’s depth and whether it has spread to adjacent lymph nodes or vital structures, such as major blood vessels. A physician can also obtain tissue samples from the tumor or lymph nodes to help in the diagnosis and management of the condition.

How Does One Prepare for an Endoscopic Ultrasound?

• Your doctor will review your current medications and determine if you need to temporarily stop taking any medication
• You will need to make your doctor aware of any allergies including latex allergies.
• You wil also need to inform your doctor of ay chronic conditions such as heart disease, diabetes or bleeding issues
• Do NOT eat or drink anything six hours before your procedure
• Your doctor will tell you when to begin fasting and when you should stop taking any medication
• If your EUS is for the colon, your doctor will recommend laxatives, enemas, and a liquid diet before the test to clean out the colon
• You may be instructed to take an antibiotic before an EUS if you are having a cyst drained or fluid collected. Since you will be given sedatives, you will not be able to drive after the procedure. You should arrange for someone to take you home, and you should also have that person stay with you at home for the remainder of the day since sedatives can slow your reflexes and affect your judgment

How is an Endoscopic Ultrasound Performed?

An endoscopic ultrasound is an outpatient procedure and you will be able to go home on the same day. For an upper GI endoscopic ultrasound, you will receive an intravenous sedative to help you relax. You may be instructed to lie on your left side, and your doctor will pass the endoscope through your mouth, down your esophagus and into your stomach and small intestine. The scope should not affect your breathing, and most people do not remember the procedure. Some people find the test a bit uncomfortable, but many people fall asleep. Your doctor will be able to view your intestinal tract on a TV monitor and the ultrasound image on another monitor. The entire process can take 30 to 90 minutes.

For a lower GI endoscopic ultrasound, you may also receive medication to help you relax. You will lie on your side and your doctor will insert the endoscope into the rectum. The procedure takes about 45 minutes, on average, but it can take longer if a cyst needs to be drained.

What Happens After the Endoscopic Ultrasound is Done?

You will remain in a recovery area for monitoring until the sedative has worn off. You may be sleepy for up to an hour after the procedure and you should not eat or drink until you have been given permission to do so. Once you are completely awake, your doctor will share the results of your test with you. If biopsies were obtained or fluid was removed, it may take several days to get the final results of the procedure.

After this, your caregiver can take you home if you feel well enough to leave.

If you have had an upper GI endoscopic ultrasound, you may have a sore throat, but gargling with salt water should help to soothe any discomfort. If you had a lower GI endoscopic ultrasound, you may feel bloated by the air that was introduced during the procedure. These symptoms should only be temporary and should resolve over the course of a few hours.

It is rare for complications to occur after an endoscopic ultrasound but you may experience:

• Sore throat
• Bleeding if a biopsy was obtained or fluid was removed
• Aspiration of stomach contents into the lungs
• Infection
• Perforation of the lining of the intestine
• Vomiting
• Chills
• Fever
• Abdominal pain

Endoscopic ultrasound offers medical professionals clear, detailed images of your gastrointestinal tract to help diagnose upper and lower GI issues. If you have further questions about EUS, please contact your gastroenterologist.

What are the Risks Associated With an Endoscopic Ultrasound (EUS)?

Overall, the risks are very low with an Endoscopic Ultrasound. The following have a possibility of occurring:

• Bleeding from biopsy
• Perforation or deep tear in the lining of the gastrointestinal tract
• Pancreatitis if tissue samples are taken from the pancreas