What is Endoscopic Ultrasound?
Endoscopic Ultrasound (EUS) is a diagnostic and very useful therapeutic tool to evaluate abnormalities of the gastrointestinal tract. Rarely, we can even investigate problems beyond the gastrointestinal tract. This involves the passage of a specially designed endoscope that is equipped with an ultrasound probe on its tip, and enables your endoscopist to image the local anatomy of the GI tract and beyond. A few indications of this procedure include evaluation of gastrointestinal cancer (esophageal, gastric, pancreatic, and rectal) for staging purposes, diagnosis of abnormalities of the pancreas, diagnosis of lesions of the wall of the GI tract, and even therapy designed at relieving pain from pancreatic malignancy. Some example images are displayed for your information. All images were from procedures performed by either Dr. Garza or Dr. Lunt, who are two of the only gastroenterologists in southern Colorado trained to perform these procedures.
The procedure is more involved than traditional endoscopy, and lasts longer, typically 30 to 60 minutes.
The above sequence of pictures demonstrate a radial EUS procedure performed by an Associates in Gastroenterology physician. Drs. Lunt and Garza perform endoscopic ultrasound. This patient has cystic lesions of the pancreas and liver, and EUS can be used to visualize the cysts and local anatomy, and also to sample the cyst via biopsy.
What preparation is required for an EUS?
We ask that you not eat or drink for 6 hours before your procedure.
In addition, we ask that you stop these medications:
Please check with the doctor who prescribed them before stopping them!
7 days prior to your procedure:
- All aspirin and NSAID’s (Aleve, Motrin, Advil, Naprosyn, Vioxx)
Anti-platelet medications (Plavix, Pletal, Ticlid, Aggrenox)
Gingko Biloba, Ginger, Garlic
5 days prior to your procedure:
- All blood thinners (coumadin/warfarin)
2 days prior to your procedure:
- Iron supplements
12 hours prior to your procedure:
- Lovenox, Fragmin
What happens before your procedure?
This procedure will be performed at Penrose Hospital. Please check in to the GI lab one hour before your procedure time.
What happens during the procedure?
The instrument will be inserted through the mouth and into the duodenum (small intestine), or may involve examination of the lower aspect of the colon. Your physician may instill water or air to help with visualization.
Areas of abnormal tissue will be biopsied, and photos of the areas will be obtained and reviewed with you. If a biopsy is performed, your physician will go over this with you afterwards and remind you not to take aspirin or NSAIDs for several days afterward.
What happens after your procedure?
After your procedure, you will be monitored and allowed to recover from the sedation. This typically takes 30 minutes to one hour. Your abdomen may be a little sore for a while, and you may feel bloating or cramping right after the procedure because of air introduced into your GI tract during the test.
With rare exceptions, most patients can resume a normal diet immediately afterwards.
You will go home with a copy of your procedure report, and your referring physician will receive a copy in the mail usually within one week.
What are the possible complications of an EUS?
EUS is generally safe and complications are rare when the test is performed by a Board-certified gastroenterologist. Complications, in brief, can include infection, perforation of the gastrointestinal tract, bleeding, and rarely, inflammation of the pancreas (this is typically around 1% when attempting to diagnose lesions of the pancreas). Your Associates in Gastroenterology physician will discuss this procedure at length with you before scheduling it. Also, irritation may occur at the vein where medications were given, sometimes leaving a tender lump lasting for several weeks. Applying hot moist towels may help relieve discomfort. Other rare risks include a reaction to the sedatives used or aggravation of heart or lung diseases.
Please call immediately if after the procedure you develop fever, significant pain, or bleeding.