Endoscopic ultrasound (EUS) is a specialized procedure that combines endoscopy and ultrasound to obtain detailed images of the digestive tract and surrounding structures. It is particularly useful for assessing conditions in the upper gastrointestinal (GI) tract, including the esophagus, stomach, and duodenum, as well as the lower GI tract and surrounding organs like the pancreas, liver, and gallbladder.
Indications for Endoscopic Ultrasound:
- Diagnosis: Evaluating conditions such as pancreatitis, pancreatic tumors, or cysts, and gastrointestinal cancers.
- Staging of cancer: Determining the extent of cancer spread to lymph nodes or surrounding tissues.
- Guided biopsies: Obtaining tissue samples from masses or abnormal areas that may be difficult to reach through traditional methods.
- Drainage: Assisting in the drainage of fluid collections, such as abscesses or cysts.
The Procedure:
- Preparation: Patients may be asked to fast for several hours before the procedure. Medications may need to be adjusted, particularly anticoagulants.
- Sedation: Most patients receive sedation or anesthesia to ensure comfort during the procedure.
- Insertion of Endoscope: A flexible endoscope equipped with an ultrasound probe is inserted through the mouth (for upper GI EUS) or rectum (for lower GI EUS).
- Ultrasound Imaging: The ultrasound probe emits sound waves that create detailed images of the digestive tract and adjacent organs. The physician can visualize the layers of the intestinal wall and surrounding structures.
- Interventions: If necessary, the doctor can perform:
- Biopsy: Taking tissue samples for laboratory analysis.
- Fine-needle aspiration (FNA): Removing fluid or tissue from masses for further evaluation.
- Drainage procedures: For fluid collections or abscesses.
Risks and Complications:
- Bleeding: Especially if a biopsy or FNA is performed.
- Perforation: A rare but serious complication where the endoscope creates a hole in the GI tract or surrounding structures.
- Infection: Possible, though uncommon.
- Adverse reactions: To sedation or anesthesia.
Aftercare:
- Patients are monitored for a short period post-procedure until the sedation wears off.
- They may experience mild discomfort or bloating, which typically resolves quickly.
- Instructions regarding diet and activity will be provided based on the findings and any interventions performed.
When to Seek Medical Attention:
- Severe abdominal pain or bloating.
- Fever or signs of infection.
- Persistent bleeding or changes in bowel habits.