Endoscopic Ultrasound (EUS)

EUS is a low-risk diagnostic procedure, combining both endoscopy and ultrasound.
        Endoscopy– physician inserts a thin, flexible tube with a light and camera at the end to visualize structures within the digestive tract
        Ultrasound– uses high-frequency ultrasound waves to obtain detailed images of structures within the body
EUS is an advanced endoscopic technique that was initially developed in the 1980s and later gained wider clinical application with advancement in technology and physician training. A miniaturized ultrasound transducer on the end of an endoscope is advanced into either the upper or lower intestinal tract, thereby allowing ultrasound imaging of anatomical structures either within or adjacent to the digestive tract. During EUS, you are adequately sedated under monitored anesthesia care (i.e. propofol) by a skilled anesthesiologist or certified registered nurse anesthetist. EUS takes approximately 30 to 90 minutes to perform, and you can return home when the procedure is finished. You will need a responsible adult to accompany you to the procedure so that you can be safely transported home after completion and recovery from the procedure.

Why is EUS performed?

EUS is used to help diagnose a number of gastrointestinal disorders. The following is a list of common indications for EUS.
  • Stage gastrointestinal cancers (determine how advanced the cancer is)
  • Detection and biopsy of solid or cystic tumors within the pancreas
  • Detection of small stones in the bile ducts
  • Evaluation of recurrent acute pancreatitis
  • Evaluation of small “lumps or bumps” (i.e. submucosal tumors) seen within the intestinal tract on general endoscopy
  • Treatment of pain associated with advanced pancreatic cancer or chronic pancreatitis (i.e. EUS-guided celiac plexus neurolysis)
  • Drainage of pseudocysts associated with complications from either acute or chronic pancreatitis (typically require overnight observation/hospitalization following the procedure)
Your physician may need to perform a biopsy (fine-needle aspiration or FNA) during the procedure to confirm the diagnosis. A thin needle is passed through the endoscope and across the intestinal wall under ultrasound-guidance into the tissue of interest. The sample is then sent to the pathology lab for analysis. A biopsy may help to confirm the presence of cancer or whether the cancer has spread to other organs. EUS-guided FNA is generally a low-risk procedure with higher diagnostic accuracy when compared to conventional radiological techniques (i.e. ultrasound or CT-guided biopsy).

What to Expect on the day of your EUS?

Prior to your procedure, you will need to follow specific preparation instructions. The following is a list of general instructions prior to the procedure.
  • If you are having EUS of the upper gastrointestinal tract, you may not eat or drink for six to eight hours prior to the procedure to insure that the intestinal tract is clear of food products.
  • If you are having EUS of the lower gastrointestinal tract, you will need to follow a liquid diet followed by either an enema on the day of the procedure or a laxative preparation, similar to a colonoscopy, on the day prior to the procedure.
  • If you have any medication allergies, please inform your physician.
  • Your physician will instruct you regarding any prescription medications you are taking. In general, coumadin (warfarin) should be held five days prior to the procedure, and plavix (clopidogrel) should be held seven days prior to the procedure. Holding these medications should be discussed with your physician prior to the procedure.
On the day of your procedure, arrive one to two hours prior to the scheduled procedure time to allow ample time for registration and preparation. The following is a general description of events that will follow.
  • An IV will be inserted to allow administration of fluids and sedatives.
  • If EUS is performed on the upper gastrointestinal tract, generally a topical anesthetic will be applied to the throat since the endoscope passes through the mouth.
  • The physician will then insert the endoscope through either the mouth or rectum, observing both the endoscopic and ultrasound images on a nearby monitor.
  • A biopsy (FNA) will be performed if necessary.
  • After the procedure, you will be transported to recovery where your physician will discuss the findings with you. You may then return home, accompanied by a responsible chaperone, and rest for the remainder of the day.
If you have any questions regarding your EUS procedure, please contact Dr. Sanders office at 251-414-5900 prior to the date of your procedure.
EUS is a low-risk diagnostic procedure, combining both endoscopy and ultrasound.