Endoscopic ultrasound (EUS) is an advanced endoscopic procedure that allows your gastroenterologist to look inside your gastrointestinal tract and to evaluate the lining as well as the walls of the GI tract. It also allows the evaluation of other organs located outside the GI tract such as the pancreas, liver, and gallbladder. The test is performed using an endoscope, which is a thin tube with a camera and a light on its end that also has a built-in miniature ultrasound probe. The doctor inserts the scope through your mouth or anus and advances it to the area to be examined. Sound waves are then used to create images of the GI tract and surrounding organs. The images are transmitted from the scope to a monitor so the doctor can see inside and around your GI tract. The scope also has a channel that the doctor can use to insert instruments and perform diagnostic and therapeutic interventions such as performing fine needle aspiration or biopsy.
Endoscopic ultrasound is a very safe, effective and well-tolerated procedure. The test is used to evaluate certain conditions that can cause abdominal pain or weight loss. It can be used to evaluate lesions and lumps seen during endoscopy or abnormalities noted on other imaging techniques such as CT scan. EUS is used to diagnose diseases of the pancreas, gallbladder and bile ducts. It is also a very important tool used in the evaluation of certain cancers. It allows the doctor to accurately assess the cancer’s depth and whether it has spread to adjacent lymph nodes or invaded nearby blood vessels.
Preparing for your endoscopic ultrasound:
You will receive specific instruction when you are scheduled for the procedure explaining the preparation process. This is usually very simple as you do not need to drink any cleansing solution before an upper endoscopy. You can not eat any solid food the day of your procedure but you can usually continue to drink clear liquids up to four hours before your procedure. For EUS of the rectum or the colon, you will be given instructions to drink laxatives and possibly use enemas the day before and the morning of the procedure.
Before the procedure, you will be evaluated by the anesthesia team and the nursing staff. You will be asked to put a gown on. An intravenous access will be placed and your vital signs checked. Your doctor will talk to you about the risks, benefits, and alternatives of the procedure and you will be asked to sign an informed consent form to give the doctor permission to perform the procedure.
The procedure performed in a private room with only your gastroenterologist, the anesthesiologist and the nurse and tech assisting in the procedure present in the room. Sedation will be administered through the IV line and you will be asleep and comfortable. The scope is inserted through the mouth or the anus and advanced to the area to be examined. Your doctor will carefully examine your GI tract lining as well as wall layers and surrounding organs. If needed, a needle can be introduced through the scope and advanced under ultrasound visualization into an abnormal area to aspirate a cyst or obtain a biopsy of a mass or lymph node. The tissue obtained can then be sent to the pathology lab and looked at under the microscope.
After the procedure:
An endoscopic ultrasound usually takes 30 minutes to an hour depending on whether any fine needle aspiration or biopsy is being performed. When the procedure is over, the sedation will be stopped and you will wake up and be taken to the recovery room. Most patients wake up not even realizing that the procedure had occurred. After the sedation completely wears off, your doctor will talk to you about the procedure and discuss with you the findings and the recommendations.
You will need someone to take you home after the procedure as after receiving sedation you are not allowed to drive or go to work or leave the endoscopy unit by yourself. The next day you will be back to your normal routine.