What is endoscopic ultrasound (EUS)?
An endoscopic ultrasound (EUS) procedure examines the inside of your digestive tract. It can detect pancreatic cancer, colon cancer, as well as cancer that's spread to other parts of your body. EUS can also detect inflammatory bowel disease (IBD), pancreatitis and other causes of abdominal pain.
A gastroenterologist performs an EUS.
An EUS test combines:
- Endoscope, a long, thin, flexible tube with a camera and light on the end.
Ultrasound, a probe on the end of the endoscope that sends out sound waves to produce images of your organs, tissues and blood vessels.
Who needs an endoscopic ultrasound (EUS) procedure?
gastroenterologist use EUS to evaluate or diagnose:
- Abdominal (belly) pain or chest pain.
- Cancer spread (metastatic cancer).
- Lumps, lesions (abnormal tissue) or growths seen on previous imaging scans like CT scans or MRIs.
- Digestive tract problems, such as inflammatory bowel disease (IBD), colon cancer and anal fissures.
- Gallbladder diseases, including gallstones and cholecystitis (gallbladder inflammation).
- Lung diseases, such as lung cancer.
- Pancreatic diseases, such as pancreatic cancer, pancreatic cysts and pancreatitis.
- Swallowing disorders like Barrett’s esophagus.
What are the types of EUS tests?
An upper endoscopy procedure is an EUS procedure that examines the upper part of the digestive tract, including:
- Lining of the esophagus, stomach and small intestine.
- Lymph nodes, blood vessels, cysts and tumors.
- Nearby organs, such as the pancreas, gallbladder and bile ducts.
A lower EUS procedure examines the lower part of your digestive tract. This includes:
- Anal sphincter (muscles surrounding the anus).
- Blood vessels, lymph nodes, cysts and tumors.
- Lining of the large intestine (rectum and colon).
What other procedures take place during an EUS test?
Your healthcare provider may perform endoscopic ultrasound-guided fine-needle aspiration. In this procedure, your provider uses EUS to guide a needle biopsy to remove a small sample of tissue or fluid. The sample goes to a lab where a lab specialist (pathologist) examines it for signs of disease, such as abnormal or cancerous cells.
What happens before an endoscopic ultrasound (EUS) procedure?
Your healthcare provider will tell you what you should and shouldn’t do before an EUS test. In general, you may need to:
- Adjust the dosage of your medications such as blood thinners or insulin as recommended by your provider.
- Not eat or drink for a set period of time before the test.
- Use a prescription bowel prep to clean out your bowels (for a lower EUS only).
- Hold off “blood-thinning” medications
What happens during an upper endoscopic ultrasound?
An upper EUS test is an outpatient procedure. You’ll go home the same day. Because you receive a sedative (anesthesia), someone needs to drive you home and stay with you for the remainder of the day. An upper EUS procedure takes about 60 minutes.
During an upper EUS test, you lie on your left side. A healthcare provider:
- Gives you an IV sedative to help you relax.
- Sprays your throat with a numbing medicine.
- Places a plastic mouthguard in your mouth. The mouthguard protects your teeth and prevents you from biting down on the endoscope.
- Inserts the ultrasound endoscope through your mouth, esophagus and stomach until it reaches the duodenum (top part of the small intestine). You shouldn’t feel any pain. You will be able to breathe as usual.
- Looks at ultrasound images on a monitor to examine your upper digestive tract, nearby organs, cysts or tumors.
- If needed, uses the ultrasound images to thread a thin needle through the endoscope to take a sample of tissue or fluid.
- Gently removes the endoscope and stops anesthesia. You slowly wake up in a recovery room.