Endoscopic Ultrasound (EUS)
Endoscopic UltraSound (EUS) is a procedure to obtain images and information about the digestive tract and the surrounding tissue and organs. Ultrasound testing uses sound waves to make a picture of internal organs.
During the procedure, a small ultrasound device is installed on the tip of an endoscope. An endoscope is a small, lighted, flexible tube with a camera attached. By inserting the endoscope and camera into the upper or the lower digestive tract, the doctor is able to obtain high-quality ultrasound images of organs. The EUS can get close to the organ(s) being examined. The images obtained with EUS are often more accurate and detailed than images provided by traditional ultrasound that travels from outside the body.
Uses of Endoscopic UltraSound (EUS)
- Evaluate stages of cancer
- Evaluate chronic pancreatitis or other disorders of the pancreas
- Study abnormalities or tumors in organs, including the gallbladder and liver
- Study the muscles of the lower rectum and anal canal to determine reasons for fecal incontinence
- Study nodules (bumps) in the intestinal wall
What is EUS?
Endoscopic ultrasound (EUS) is a minimally invasive endoscopic procedure that allows your doctor (gastroenterologist/endoscopist) to obtain detailed images of digestive system organs. EUS provides more information than that obtained with CT or MRI imaging. It can be used to take needle biopsies from abnormal digestive organ areas, avoiding exploratory surgery. It can also be used to take sample fluid from a cyst.
How is EUS performed?
A thin, flexible tube (endoscope) is passed through the mouth and into the stomach and duodenum. The tip of the endoscope contains a built-in miniature ultrasound probe and emits sound waves. These sound waves pass through the lining of the stomach and duodenum creating a visual image of the pancreas and surrounding tissue. EUS may be used to obtain a needle biopsy of the pancreas or to sample fluid in a pancreatic cyst. This is done by passing a very thin needle from the endoscope into the pancreas under continuous ultrasound monitoring. This technique is called EUS-fine needle aspiration (EUS-FNA) and does not hurt.
Where is EUS performed?
EUS is performed in Outpatient Services at Lexington Medical Center – at either the West Columbia or St. Andrews campus. Procedures are performed by appointment and by your gastroenterologist. As you will be receiving intravenous (IV) sedation you will not be allowed to drive after the procedure. It is important that you have a family member or friend take you home and plan to stay with you at home after the examination as sedatives can affect your judgement and reflexes for up to twenty-four hours.
Can I eat before the procedure?
If your procedure is scheduled before 12 pm, do not eat or drink anything after midnight. If your procedure is scheduled after 12 pm you may have clear liquids until 8 am on the day of the test.
Should I take my medications?
If you are taking medication for high blood pressure, seizures, or if you are taking prednisone, you may take these medications in the morning on the day of the procedure or at least two hours before the procedure with a sip of water. Do not take water/fluid pills after midnight on the night before your procedure. If you take aspirin or anticoagulant medications, such as warfarin (Coumadin), heparin or clopidogrel (Plavix), contact your prescribing physician for instructions on when to stop taking your medication prior to your procedure. In general non-steroidal anti-inflammatory medications (naproxen, ibuprofen, etc.) should not be taken for one week prior to an EUS examination. If you have any other EUS medication questions, call our office at (803) 794.4585.
Will I be awake for the procedure?
The EUS procedure is performed using intravenous sedatives and helps you relax. Depending on the sedation used, you may not remember the procedure. Most patients consider the procedure only slightly uncomfortable, while some fall asleep during it.
How long does the procedure take and what happens afterwards?
The actual procedure takes approximately 45-60 minutes. Most patients are discharged 3-4 hours after they arrive. Following the procedure, you will be monitored in the recovery area until the effects of the sedation have worn off. You will be able to eat after the procedure.
Will I be admitted for the procedure?
The procedure is performed as an outpatient procedure. Most people are able to go home one to two hours after completion of the procedure.
When will I be given the results of the EUS?
Your gastroenterologist will usually be able to give you the preliminary results of the EUS on the same day as the procedure. If an EUS-FNA has been performed, these results take between five to seven days to return. What are the possible complications associated with EUS? EUS is a very safe procedure and although complications occur, they are rare when doctors with specialized training and experience perform the EUS examination. You may have a sore throat and usually resolves within a day or two. Sometimes people feel a little bloated due to the air inserted by the instrument. Other potential but uncommon complications of EUS include a reaction to the sedatives used, aspiration of stomach contents into your lungs and complications affecting the heart or lungs. One major, but very uncommon complication of EUS is where there is a tear in the lining of the stomach or duodenum, called a perforation. This is very rare but can require surgery to repair the tear. If an EUS-FNA is performed, where a needle is passed into the pancreas to take a sample, there is a small risk of bleeding, pancreatitis or infection. To decrease the risk of infection, we routinely prescribe antibiotics for patients in whom EUS-FNA was performed on a pancreatic cyst.
If you have any other questions about your EUS procedure, please do not hesitate to contact our office at (803) 794.4585.