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Endoscopic Ultrasound (EUS)

What is an Endoscopic Ultrasound (EUS)?

An Endoscopic Ultrasound (EUS) is a procedure that enables the doctor to examine the lining and layers of the upper gastrointestinal tract, including oesophagus (gullet), stomach, duodenum (first part of the small intestine that is connected to the stomach) and the surrounding areas and organs such as the pancreas and gallbladder.

The procedure involves passing a small flexible camera with an ultrasound probe at the tip, down your oesophagus, into the stomach and duodenum.

 

Why is EUS performed?

EUS is usually performed for the following reasons:

  • To examine the pancreas, bile duct and gallbladder
  • To assess lesions in the wall of the oesophagus or stomach
  • To examine lymph glands
  • To obtain a biopsy (tissue sample)
  • To provide further information about whether you need surgery.

 

Before your Appointment

  • It is essential that you have nothing to eat for six hours before your appointment.
  • You can drink water for up to two hours before your appointment.
  • After that you must have nothing to eat or drink until after the procedure

 

During the Procedure

You will not need to undress for the EUS.

In the endoscopy room you will be made comfortable on a couch, lying flat on your left side. A nurse will stay with you throughout the procedure. A plastic mouthpiece will be placed gently in your mouth to protect your teeth and endoscope. When the endoscopist passes the endoscope through the mouthpiece and into your stomach, it will not cause any pain, nor will it interfere with your breathing at any time. During   the procedure, some air will be passed down the endoscope to distend the stomach and allow the endoscopist to have a clear view. The air is sucked out at the end of the procedure. When the procedure is finished the endoscope is removed quickly and easily. The procedure lasts approximately 45 minutes from entering the endoscopy room, but you should expect to be in the gastroenterology unit for about 2-3 hours in total.

 

Sedation

  • EUS is carried out under sedation.
  • You cannot have the procedure unless you bring someone with you to the appointment
  • Someone must escort you home and stay with you for 24 hours afterwards.

Sedation is a medicine given by injection to help you to relax. Whilst this will make you drowsy, it does not ‘put you to sleep’ like a general anaesthetic.

The sedative medicine will not be completely out of your system until 24 hours after the procedure. During this time, you must not:

Drive a motor vehicle, Drink Alcohol, Operate Machinery or Sign Legal Documents

If you have any queries, please phone the gastroenterology unit on 01603 647594 for advice.

 

Privacy and Dignity

In order to protect the privacy and dignity of all patients, some of whom may be undressed for procedures, relatives/carers will NOT be allowed to stay with the patient for the whole time. They are welcome to accompany the patient during the initial admission process but will then be required to leave the admission/recovery area once the patient has been made ready for the procedure. Relatives/carers will be invited back once the patient is recovered and ready for discharge.

 

Medicines and Medical Conditions

Please bring a list of your current medication with you and give it to the nurse on arrival.

If you have a latex allergy, please telephone the gastroenterology unit on 01603 647594 for advice.

Warfarin / Phenindione / Clopidogrel (Plavix), Apixaban, Dabigatran, Ticagrelor, Prasugrel, Low Molecular Weight Heparin, Intravenous Heparin, or any other blood thinning agent (anti- coagulant)

If you are taking any of the above, please inform the gastroenterology unit on 01603 647594 as soon as possible, as our doctors may decide that it is necessary for you to stop taking your tablets for a limited time before the procedure.

Diabetes

If you suffer from diabetes, please inform the gastroenterology unit as soon as possible on 01603 647594, as it may be necessary to change the time of your appointment or be admitted to hospital a day before your procedure for treatment. If your diabetes is managed by your GP, please contact the surgery for advice. If under the care of Elsie Bertram Diabetes Centre, please contact your diabetes specialist nurse on 01603 286286.

Pregnancy

If you are pregnant or breast-feeding, please contact the gastroenterology unit on 01603 647594 for advice.

Consent

A consent form is enclosed for you to read before you come for your appointment. This is to ensure that you understand the test and its implications/risks. Please bring it with you but DO NOT sign it until AFTER you have had a discussion with the nurse or doctor in the gastroenterology unit. If you have any queries, you can telephone the gastroenterology unit before your procedure, on 01603 647594 or ask the staff when you have your discussion.

 

After the Procedure

You will be monitored in the gastroenterology unit for a short time after the procedure. The doctor will then come and talk to you, explaining what has been found. If a biopsy has been taken, your hospital specialist will inform you of the result and any necessary treatment.

Once you have returned home, or back to your ward, you may begin to eat and drink normally and resume your normal medication, unless instructed otherwise by the doctor.

Side effects of this procedure are usually minimal; sometimes patients may feel bloated and / or have a sore throat for the rest of the day. This can be relieved by taking your normal painkillers. You will be given an advice sheet on after-care and signs to watch for when you have had your procedure.

 

What are the Risks and Complications?

EUS is a safe investigation, but there is small risk of complications:

  • The oesophagus, stomach or intestine may rarely be damaged or perforated during the procedure. The risk of perforation is approximately 1 in 1000. A perforation will usually require surgical treatment.
  • There is a small risk of bleeding if any biopsy is taken, and of pancreatitis (inflammation of the pancreas) if a biopsy is taken from the pancreas. The risk of this is approximately 1 in 100.
  • There is a very small risk that you may react to the sedative medicine, or that it might affect your heart rate or breathing. You will be monitored carefully throughout the procedure.
  • There is a slightly increased risk of chest infection after the procedure.