Endoscopic Ultrasound

What is Endoscopic Ultrasound?

Endoscopic Ultrasound (EUS) combines endoscopy and ultrasound to obtain in-depth images and information about the digestive tract and surrounding organs. In EUS, a small ultrasound transducer is incorporated at the tip of an endoscope. This allows the transducer to get close to organs inside the body and obtain more accurate and detailed images. Tissue can be obtained from enlarged lymph nodes or suspicious tumors by passing a needle through the endoscope (FNA). The different layers of the digestive tract can be seen separately and the depth of tumor involvement can be more accurately assessed. This information is helpful in deciding type and duration of cancer therapy.

Diagnostic Indications:

• Esophagus: Esophageal cancer staging, evaluation of Barrett’s esophagus with high-grade dysplasia. Evaluation of submucosal lesions.

• Stomach: Evaluation of gastric cancer, including MALT lymphoma. Submucosal mass lesions. Biopsy of perigastric and retroperitoneal lymph nodes.

• Pancreatico-Biliary Disorders: Pre-operative cancer staging such as pancreatic cancer, ampullary cancer and cholangiocarcinoma. Unexplained abdominal pain to rule out chronic pancreatitis. Evaluation of cystic lesions of the pancreas. Localization of functional neuroendocrine tumors. Suspected choledochalithiasis.

• Colorectum: Pre-operative rectal cancer staging. Evaluation of pelvic and peri-anal disease such as Crohn’s fistulas or fecal incontinence.

• Staging of Lung Cancer: Evaluation of mediastinal lymph nodes in lung cancer and unexplained mediastinal masses by FNA.

Therapeutic Indications:

• Pain Control for chronic pancreatitis and pancreatic cancer using celiac plexus, neurolysis or celiac plexus block.

• Pseudocyst Drainage (Endoscopic Cystgastrostomy)

• EUS-guided bile duct access in cases of ampullary obstruction.