Mankanwal Sachdev, MD, a gastroenterology and internal medicine specialist at Banner Gateway Medical Center in Gilbert, Ariz.
Question: A CT scan detected a suspicious spot on my pancreas and my doctor suggested an endoscopic ultrasound to evaluate it. What is involved?
Answer: While endoscopic ultrasound (EUS) has been around since the 1980s, it didn’t start gaining popularity until about five to 10 years ago. It is used in a wide range of diagnostic, biopsy, staging and treatment procedures, most notably those related to gastrointestinal cancers. However, EUS also is used to help evaluate the presence or source of abdominal pain, gall stones, unidentified lumps in the stomach and more.
EUS is a combination of traditional endoscopy and ultrasound in a single, more advanced procedure. It entails passing a long flexible tube known as an endoscope over the tongue and past the esophagus and stomach to provide access to the entire digestive tract, including the layers of the intestinal lining, surrounding tissues and nearby organs. By virtue of having a small ultrasound transducer mounted on the tip of the device, physicians can view the area with greater detail and clarity than through traditional ultrasound.
This enhanced precision and image quality has proven effective in identifying tumors previously missed through CT and MRI due to size and/or location, as well as determining the exact layer in which a tumor begins. Such accuracy ensures physicians can make the most informed treatment plans. It also allows for on-the-spot removal of benign polyps in some cases and the ability to inject chemotherapy directly into tumors, in turn, sparing surrounding healthy tissue.
To minimize any pain or discomfort, patients undergoing EUS are sedated. They are generally required to fast for six hours in advance, though only a simple enema may be needed in some cases.
Not all patients are candidates for EUS and not all gastroenterologists perform the procedure. Speak with your physician and discuss your complete health history to ensure EUS is right for you.