Endoscopic Ultrasound
What is an Endoscopic Ultrasound (EUS)
An Endoscopic Ultrasound (EUS) is a specialized procedure that combines endoscopy and ultrasound to obtain detailed images of the digestive tract and nearby organs, such as the pancreas, liver, and lymph nodes. During EUS, a thin, flexible tube with an ultrasound probe is inserted through the mouth or rectum, allowing doctors to closely examine tissues and diagnose conditions. This procedure can also guide biopsies for a more accurate diagnosis without invasive surgery.
Diagnostic EUS
Diagnostic EUS is a procedure that is used to evaluate growths in the lining of the oesophagus and stomach, pancreatic cysts and masses, bile duct strictures, abnormal lymph nodes, and other nearby structures. When required, a sample may be taken under EUS guidance, and this is termed a fine needle aspiration (FNA) or fine needle biopsy (FNB).
Therapeutic EUS
EUS can treat a number of conditions within and adjacent to the gastrointestinal tract.
Some of the therapeutic EUS procedures the MIG doctors perform are:
Luminal connection
Under EUS guidance, structures next to the stomach and small bowel can be accessed and connected together internally. These are minimally invasive techniques which allow internal treatment with less intervention and faster recovery.
Cystenterostomy
An EUS-guided cystenterostomy is the internal drainage of collections such as pancreatic pseudocysts or abscesses to the gastrointestinal tract. A stent (tube) is placed between the stomach or small bowel, and the cystic collection nearby.
Gastro-jejunostomy
An EUS-guided gastro-jejunostomy is a connection between the stomach and jejunum, which allows food to empty from the stomach when there is a blockage at the exit point of the stomach or duodenum.
Cholecystoduodenostomy
An EUS-guided cholecystoduodenostomy is where a connection is made between the gallbladder and the duodenum. This is performed to treat gallbladder infection when gallbladder surgery is contraindicated, for example due to underlying significant medical issues.
Choledochoduodenostomy
An EUS-guided choledochoduodenostomy is where a blocked bile duct (due to stones or cancer) is accessed and drained by EUS from the duodenum. This is particularly useful if the bottom of the bile duct can’t be reached by the usual ERCP method, or if an ERCP has been unsuccessful.
Coeliac plexus block and neurolysis
Coeliac plexus block and neurolysis are procedures used to relieve abdominal pain by targeting the coeliac plexus, a bundle of nerves located in the upper abdomen. A block involves injecting medication to disrupt pain signals in chronic pancreatitis, while neurolysis involves using chemicals to permanently destroy nerve tissue, providing pain relief for conditions like pancreatic cancer.
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