Endosonographic Ultrasound

What is an Endosonographic Ultrasound?

Endosonographic Ultrasound (EUS) is a diagnostic tool that combines endoscopy and ultrasound technology to create a more comprehensive and accurate image of the digestive system. 

The endoscope is a flexible tube with a tiny camera and light on the end, which is inserted into the patient's mouth and guided through the digestive system. 

Ultrasound technology emits high-frequency sound waves that bounce off internal organs, creating a detailed image of the gastrointestinal tract and surrounding structures.

Who is Suitable for Endosonographic Ultrasound?

Endosonographic Ultrasound is suitable for patients with a variety of gastrointestinal issues. It is often used to diagnose and stage gastrointestinal cancers, including pancreatic, esophageal, and rectal cancer. It can also evaluate the severity of inflammatory bowel disease, including Crohn's disease and ulcerative colitis, and diagnose gallbladder and liver diseases.

Why is Endosonographic Ultrasound Performed?

EUS is used to diagnose symptoms including:

• causes associated abdominal or chest pain
• determine the extent of diseases in your digestive tract and lungs, and 
• to evaluate findings from imaging tests such as CT scans or MRI

What are the Benefits of Endosonographic Ultrasound?

One significant benefit of Endosonographic Ultrasound is its ability to provide detailed images of the digestive system that are impossible with other diagnostic tools. This makes it an essential tool for diagnosing and staging gastrointestinal cancers, which is crucial for determining the appropriate treatment plan. 

In addition, EUS is a minimally invasive procedure that typically does not require sedation and has few risks or complications.

Another benefit of Endosonographic Ultrasound is its ability to provide real-time images during procedures. This allows doctors to precisely perform biopsies and other treatments, minimising the need for additional procedures and reducing the risk of complications.

What are the Types of Endosonographic Ultrasound?

There are two types of Endosonographic Ultrasound: Endoscopic Ultrasound (EUS) and Endoscopic Ultrasound-Guided Fine Needle Aspiration (EUS-FNA). 

• Endoscopic Ultrasound is used to evaluate the gastrointestinal tract, nearby organs, and lymph nodes. It is often used to diagnose and stage gastrointestinal cancers, including pancreatic cancer. 
• EUS-FNA/FNB is a procedure that uses a fine needle to collect tissue samples for biopsy. It is used to diagnose and stage gastrointestinal cancers and to evaluate other conditions, such as pancreatic cysts.

What Conditions are Diagnosed by EUS?

Endoscopic ultrasound (EUS) is mainly employed in the diagnosis or investigation of the following conditions:

• oesophageal tumours
• gastric tumours
• pancreatitis and pancreatic cysts and masses
• biliary and pancreatic duct disease
• disorders of the gallbladder and liver
• mediastinal masses and lymphadenopathy 
• lower rectum and anal canal muscle disorders

Preparation Before an Endosonographic Ultrasound

• Fasting: The patient must fast for six to eight hours before the procedure to ensure the stomach and small intestine are empty.
• Medication adjustments: Patients taking blood-thinning medications or insulin may need to adjust their medication regimen before the procedure.

What Happens During an Endosonographic Ultrasound?

• The patient will be positioned on their left side, and a local anaesthetic will be applied to the back of the throat to numb the area.
• The endoscope, a flexible tube with a tiny camera and light on the end, will be inserted into the patient's mouth and guided through the digestive system.
• The ultrasound probe will be attached to the end of the endoscope, and high-frequency sound waves will be emitted to create detailed digestive system images.
• A biopsy may be taken during the procedure using a special tool passed through the endoscope if necessary.

After an Endoscopic Ultrasound

You will be monitored briefly after the procedure to ensure no complications. Recovery time can vary, but most patients can resume normal activities within a few hours.

Post-procedure Instructions

• Rest: Resting is essential after the procedure to allow the body to fully recover. Avoid strenuous physical activity for at least 24 hours after the procedure.
• Diet: You may resume your regular diet after the procedure. However, it is recommended that you start with light, easily digestible foods and gradually return to your normal diet.
• Medications: You can usually resume taking regular medications immediately after the procedure. However, your gastroenterologist will provide specific instructions if medication adjustments are required.
• Drinking fluids: Drinking plenty of fluids after the procedure is essential to help flush out any remaining air in the digestive system and prevent dehydration.
• Follow-up: Your gastroenterologist may schedule a follow-up appointment to discuss the procedure's results and any necessary treatment.

Endoscopic Ultrasound Risks

Endosonographic Ultrasound is a minimally invasive procedure that is generally safe and well-tolerated by patients. However, as with any medical procedure, there are some risks and potential complications associated with It.

Here are some of the possible risks and complications associated with Endosonographic Ultrasound:

• Bleeding: A biopsy or fine needle aspiration during the procedure may cause bleeding. However, this is a rare complication.
• Infection: There is a slight risk of infection at the site where the endoscope is inserted. The risk is higher if the patient has a weakened immune system or undergoes chemotherapy or radiation therapy.
• Perforation: In rare cases, the endoscope may cause a tear or perforation in the digestive tract. This can lead to severe pain, fever, and infection. Emergency surgery may be required to repair the perforation.
• Reaction to sedation: If sedation is used during the procedure, there is a slight risk of an allergic reaction to the medication. This may include difficulty breathing, swelling of the throat or mouth, or a drop in blood pressure.
• Pancreatitis: In rare cases, Endosonographic Ultrasound may cause pancreas inflammation, a condition called pancreatitis. This can cause severe abdominal pain, nausea, and vomiting.
• Cardiac complications: In rare cases, Endosonographic Ultrasound may cause heart rhythm or blood pressure changes. This is more likely to occur in patients with pre-existing heart conditions.

It is essential to discuss the risks and potential complications of Endosonographic Ultrasound with your gastroenterologist before undergoing the procedure. Your doctor will weigh the risks against the benefits and determine if Endosonographic Ultrasound is the best option for your medical condition.

What if Endosonographic Ultrasound is Delayed?

If Endosonographic Ultrasound is delayed, it may impact the patient's diagnosis and treatment plan. Depending on the reason for the procedure, a delay may result in a missed opportunity for early detection or treatment of a medical condition. Here are some possible scenarios if Endosonographic Ultrasound is delayed:

• Delayed Diagnosis: If Endosonographic Ultrasound is being used to diagnose gastrointestinal cancer or other conditions, a delay in the procedure may result in a delayed diagnosis. This can delay treatment, allowing the condition to progress and potentially reducing the patient's chances of recovery.
• Delayed Treatment: If Endosonographic Ultrasound is being used to stage gastrointestinal cancer, a delay in the procedure may result in a delay in treatment. This can allow cancer to progress to a more advanced stage, making it more challenging to treat.

It is essential to discuss any delays with your gastroenterologist and prioritise the procedure to ensure that it is scheduled as soon as possible. Early detection and treatment are crucial for improving the prognosis of gastrointestinal conditions, and Endosonographic Ultrasound is an essential tool for achieving this goal.