An EUS, or endoscopic ultrasound, is an outpatient procedure used to closely examine the tissues in the digestive tract. The procedure is done using a standard endoscope and a tiny ultrasound device. The ultrasound sensor sends back visual images of the digestive tract to a screen, allowing the physician to see deeper into the tissues and the organs beneath the surface of the intestines. An EUS allows the physician to get a much clearer view of an area, making this a very reliable test and preferable to more invasive procedures.
EUS can be used to evaluate:
• blood vessels
• gallstones inside the gallbladder and bile duct
• pancreas
• rectum abnormalities
• tumors and lymph nodes underneath the intestinal wall
• existing tumor growth
• tumors that appear benign
The procedure can also be used to take biopsies of tumors.
Sub Procedures
EUS with Celiac Plexus Block
This procedure uses endoscopic ultrasound (EUS) to guide a small needle to the celiac plexus—a group of nerves near the spine that transmits pain signals from abdominal organs. A long-acting anesthetic is injected to help relieve chronic abdominal pain, especially in patients with pancreatitis. The relief is temporary but can significantly improve quality of life.
EUS with Celiac Plexus Neurolysis
Like a celiac plexus block, this procedure targets the celiac plexus nerves using EUS guidance. However, instead of anesthetic, an alcohol-based solution is injected to destroy the nerve fibers permanently. It is commonly used for patients with advanced pancreatic cancer to provide long-term pain relief.
EUS with Liver Biopsy
An EUS-guided liver biopsy allows a doctor to obtain a small liver tissue sample through the stomach or intestine using ultrasound guidance. It provides a less invasive alternative to traditional liver biopsies and can be performed during a standard endoscopy, making it safer and more comfortable for the patient.
EUS with Cystogastrostomy
This procedure drains a fluid-filled collection, such as a pancreatic pseudocyst, by creating a pathway between the cyst and the stomach using EUS guidance. A small stent is placed to allow the fluid to drain into the digestive system, reducing pain, infection risk, and other complications.
EUS with EDGE (Endoscopic Ultrasound-Directed Transgastric ERCP)
EDGE is a specialized procedure for patients who have had gastric bypass surgery. It creates a temporary channel between the stomach pouch and the excluded stomach to allow access for ERCP, a procedure used to treat bile duct and pancreatic problems. This approach avoids the need for more invasive surgery.
Lower EUS
Lower endoscopic ultrasound is used to evaluate structures in the lower digestive tract, such as the rectum and surrounding lymph nodes. It is especially helpful for staging rectal cancers, evaluating pelvic masses, or identifying sources of unexplained rectal bleeding.
EUS-Guided Coiling/Gluing of Gastric and Rectal Varices
This procedure uses endoscopic ultrasound (EUS) to locate swollen veins (varices) in the stomach or rectum that are at risk of bleeding due to liver disease or portal hypertension. Through EUS guidance, a doctor can inject a medical adhesive (glue) or place small coils to seal off or reduce blood flow to the varices. This minimally invasive technique helps prevent life-threatening bleeding and is often used when traditional treatments are not effective.
EUS-Guided Gallbladder Drainage
EUS-guided gallbladder drainage is used for patients who are unable to undergo surgery to remove the gallbladder, often due to other health risks. Using endoscopic ultrasound, a doctor creates a small channel between the gallbladder and the stomach or intestine. A stent is placed to allow infected or blocked bile to drain internally. This approach is less invasive than surgery and can relieve pain, infection, and pressure from gallbladder inflammation (cholecystitis).
FAQs
An endoscope is a lighted, flexible tube with a tiny, optically sensitive computer chip at the end. As the physician moves it through the gastrointestinal tract, electronic signals are transmitted from the scope to a computer that displays the image on a video screen. An open channel in the scope allows other instruments, like the ultrasound device, to be passed through it.
When patients have symptoms of more common problems in the gastrointestinal system, like stomach ulcers or intestinal polyps, physicians use standard endoscopic procedures. Sometimes, the physician needs to get a better look at the area of concern. In those cases, the ultrasound is recommended because it helps provide a more life-like picture of your condition and allows the physicians to make a much more accurate diagnosis.
The actual exam is fairly simple and usually takes 20 to 40 minutes. You will be given a mild sedative and the physician will ask you to lie on your left side. For this procedure, the endoscope can be inserted either into the mouth or the rectum. If the endoscope is being inserted in the mouth, an anesthetic spray will be used to numb the back of your throat. Once the endoscope has been gently guided into position, the ultrasound device will begin sending images to a video screen. Once the procedure is completed, you will be taken to the recovery area.
When an EUS is done on the upper digestive tract, you cannot eat or drink anything for eight hours before the procedure. If it is being done on the lower intestine, the colon must be clean. In this case, your physician will provide you with instructions for a liquid diet and laxatives or an enema to cleanse the lower bowel. Your physician may ask you to stop taking certain medications, such as aspirin, before the procedure. Also, you should have someone drive you to and from the test.
After the examination, your physician will explain the results. If the effects of the sedatives are prolonged or a biopsy was taken, the physician may suggest a follow-up appointment to review the results.
In general, an EUS is a very safe procedure. If your procedure is being done on the upper GI tract, you may have a sore throat for a few days. As a result of the sedation, you should not drive, operate heavy machinery or make any important decisions for up to six hours following the procedure. There is a slight risk of the endoscope tearing the intestinal tract, which would require surgery. Rarely, bleeding does occur if a biopsy is taken. Serious complications are extremely uncommon.