Endoscopic ultrasound (EUS)

Endoscopic ultrasonography is recommended when other endoscopic tests provide inconclusive, incomplete or conflicting information. It may also be used to diagnose certain conditions and evaluate known disorders, including cancer. EUS lets the physician closely examine the walls and linings of the upper gastrointestinal tract (esophagus, stomach and duodenum) as well as the lower tract (colon and rectum), and nearby organs including the lungs, liver, gall bladder and pancreas.

Before the procedure begins, a sedative is delivered through an IV line in the hand or arm. Many patients fall asleep during the EUS and most do not recall the procedure afterwards.

For an upper GI tract EUS, the patient is usually given a local analgesic to numb the throat and calm the gag reflex. Then a specialized endoscope is inserted into the mouth, and advanced gently through the esophagus to the stomach and duodenum (the first part of the small intestine). For a lower GI tract EUS, the instrument is inserted into the rectum.

After the procedure, patients rest in the recovery room while the sedative wears off. Driving is not allowed for 12 to 24 hours, so patients will need a ride home.

Resting for the remainder of the day is advised. Any bloating or soreness in the throat disappears within 24 to 48 hours. Regular activities may be resumed the following day.

If the upper GI tract is being examined, the stomach must be completely empty.  If the lower GI tract is being examined, the lining of the colon must be completely clean. Complete instructions should be reviewed well in advance of the procedure. Patients with certain health conditions may require special instructions.

Although quite rare, most complications are related to sedation administration (cardiac and respiratory problems);  Rarely, bleeding, perforation, or infection may require additional treatment such as hospitalization and/or blood transfusions.