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What is EUS?
EUS involves examination of your esophagus, stomach, and duodenum with a special endoscope, inserted via the mouth. Sedation is administered by an anaesthetist. The endoscope has a video camera for visualisation and an ultrasound probe to look closely at the wall of the gastrointestinal tract and surrounding structures such as the pancreas. Reasons why people undergo an endoscopic ultrasound include; evaluation of internal masses, cysts, gastrointestinal cancers, gallstones, pancreas problems, abdominal pain, and enlarged lymph nodes in the chest. A biopsy with a fine needle may be taken at the time of the procedure.
Preparing for Your Procedure:
You may need to stop the following medications if a fine needle biopsy is required; Clopidogrel (Plavis, Iscover), Warfarin, or Aspirin (Cartia, DBL etc) although some patients should continue on Aspirin; this needs to be discussed with your doctor.
You will need to arrange for a family member or friend to drive you home. You will receive intravenous sedation during the procedure and you will not be able to drive yourself home. If you take insulin, do not take your morning dose on the day of the examination unless instructed. A plan will be formulated after discussion.
You may eat and drink solid food and dairy up until 6 hours before your procedure (i.e for a Monday afternoon procedure have an early breakfast before 0730, for a Wednesday morning procedure no solids or dairy after midnight – including milk in tea and coffee). You may have clear fluids up until 2 hours before the procedure. All usual medications otherwise should be taken with some water.
What are the benefits?
EUS is the newest intervention for gastrointestinal procedures and provides detailed information about your condition as an adjunct to the endoscopic and radiologic (x-ray) procedures you have had so far.
What are the risks?
Complications are rare.
- Bleeding occurs extremely rarely after a fine needle biopsy, and very rarely after a larger biopsy is taken. Significant bleeding requiring further intervention occurs in rare circumstances (less than 1:1000 patients).
- Infection may occur after a biopsy (less than 1:100 patients) and is more likely when a cyst is being biopsied or drained). Antibiotics will be given to cover most of this potential risk.
- A sore throat after the procedure may be due to the endoscope insertion or anaesthetic tube and this discomfort will usually be quick to resolve.
- Very frail and elderly patients may rarely get pneumonia from the stomach juices getting into the lung during the sedation.
- Reactions to the sedation are uncommon.
After the procedure?
Usually you will eat straight away and go home after the procedure. Avoid driving, operating machinery or drinking alcohol for 24 hours.
When you get home, if you notice heavy bleeding, black stools, vomiting, severe abdominal pain, OR weakness OR dizziness, OR fever over 37.5 degrees, seek medical advice. These problems are not common, but if you become unwell, you will need to call the hospital to speak to a doctor or present to the Emergency Department.