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What is Endoscopic Ultrasound (EUS) ?
- Endoscopic Ultrasound combines endoscopy and ultrasound to obtain images and information about the digestive tract and surrounding tissue and organs.
- In Endoscopic Ultrasound a small ultrasound transducer is placed at the tip of the endoscope. This allows the transducer to be very close to the organs in the body,hence images are more accurate.
- You will lie on your side with your back to the doctor while the doctor slowly passes a colonoscope along your large Intestine to look at the lining.The doctor will examine the lining again as the colonoscope is taken out.
- Endoscopic Ultrasound can visualize layers of the intestinal tract as well as adjacent areas such as lymph nodes and blood vessels, thereby playing an important role in cancer staging.
- Endoscopic Ultrasound guided Fine Needle Aspiration is carried out by passing a special needle under ultrasound guidance into enlarged lymph nodes or suspicious tumours. The cells are then examined by a pathologist under a microscope.
- Endoscopic Ultrasound may also be used for treatment such as drainage of cysts and collections.
Understanding How Endoscopic Ultrasound Performed
- Upon arrival, the doctor will explain and discuss the procedure with you and answer any queries that you may have.
- You will receive a local anaesthesia sprayed to the back of your throat and sedation administered intravenously to help you relax.
- You may sleep during the procedure.
- You will be required to lie on your side and the doctor will then pass the ultrasound scope through your month to the area to be examined.
- The examination will take about 20 to 30 minutes.
This will not interfere with your breathing.
- You will be monitored in the recovery area until most of the sedation medication effects have worn off.
- You will be able to eat unless you are instructed otherwise.
- You will usually be able to go home unless you are advised to be admitted for observation/ treatment.
- You should fast for at least 6 hours before the examination. Inform your doctor about all your medications and allergies that you may have.
- Blood thinning anticoagulants such as warfarin / Plavix / aspirin may be required to be put on hold. (Please discuss this further with your doctor).
- Antibiotics are usually prescribed if you have valve problems or where therapeutic cyst drainage is involved.
What are the risks of endoscopic ultrasound?
All procedures involve risks; which in Endoscopic Ultrasound is quite rare:
- Complication rate for Endoscopic Ultrasound without fine needle aspiration is 1:2000 and is similar to gastroscopy.
- When Fine Needle Aspiration is performed there may be a small risk of bleeding, infection or perforation (tear through the bowel) - (0.5% -1%)
- If unusual bleeding occurs, you may be hospitalized for observation.
- Infection is reduced by antibiotics which may be given before or after the procedure especially when cysts are drained.
- Bowel perforation if occurs may require surgery.
- There is a risk that small / minor abnormalities may be missed.
The list is not exhaustive.
(Please note: If a tissue sample is taken for further examination, kindly ensure you call your Doctor to obtain your results.)
What are the alternative procedures to endoscopic ultrasound?:
The alternative procedures are as follows:
- Magnetic Resonance Imaging I Magnetic Resonance Cholangiopancreatography - to evaluate for stones.
- CT guided / laparoscopic I open surgery for tissue acquisition / cancer staging.
What is Procedural Sedation?
A sedative drug is injected into a vein to induce a "sleep like" state. It makes you feel relaxed during the procedure. You may remember some or little about what has happened during the procedure.
What are the Benefits of Procedural Sedation?
To reduce pain or discomfort experienced during a medical procedure or examination.
What are the Risks of Procedural Sedation?
Procedural sedation is generally very safe but sedation has a risk with side effects and complications. Whilst these are usually temporary, some of them may cause long-term problems.
The risk to you will depend on:
- Whether you haveany other illness
- Personal factors, such as whether you smoke or are overweight.
Common Risks for All Patients
- Headache
- Faintness or dizziness, especially when you start to move around
- Pain and/or bruising at injection site
- Fall In blood pressure
Less Common Risk for All Patients
- Nausea and vomiting
- Weakness
- Temporary nerve damage
- Muscle aches and pains
- Mild allergic reaction - itching or rash
Uncommon Risk for All Patients
- Allergic reactions and/ or asthma
- An existing medical condition getting worse
- Epileptic seizure
Rare Risks
- Severe allergy or shock
- Vomit in the lungs (Pneumonia)
- Blood clot in the lungs
- Stroke or heart attack
- Paralysis
- Brain damage
You may have Increased Risks:
1. If You Are:
Elderly
A Smoker
Overweight
2. If You Have The Following:
A bad cold or flu, asthma or other chest disease
Diabetes/ Heart disease/ Kidney disease
High blood pressure
Other serious medical conditions
Alternatives
- You may opt for no sedation if you wish to.
- Under certain circumstances, the doctor may decide that the procedure be performed under deep sedation which will be administered by the anaesthetist.
- Consequences of not receiving sedation; the pain and discomfort experienced by the patient may interfere with the progression of the patient's medical examination or procedure.
