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Endoscopic Ultrasound EUS Thailand

Endoscopic Ultrasound EUS Thailand

EUS combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs.

In previous articles this month, we took a look at two similar procedures that can be used to treat or assess a wide range of symptoms.

bariatric eus endoscope Endoscopic Ultrasound EUS Thailand

The first article was a basic overview of Colonoscopy, a procedure in which a well gastroenterologist takes a look inside the anus using a device called a colonoscope.

medical news article Endoscopic Ultrasound EUS Thailand Click Here To Read Colonoscopy Article

The second was minimally invasive technique known as endoscopy. This procedure involves the surgeon inserting an endoscope (tubular probe fitted with a tiny camera and light which transmits magnified video footage to a monitor) and one or two other instruments through small incisions in the skin, enabling the surgeon to operate on a surgical site with minimal scarring.

medical news article Endoscopic Ultrasound EUS Thailand Click Here To Read Endoscopy Full Article

In this article we take a look at another variation of endoscopy, Endoscopic Ultrasound (EUS).

What Is Endoscopic Ultrasound?

EUS combines endoscopy and ultrasound in order to obtain images and information about the digestive tract and the surrounding tissue and organs.

Traditional ultrasound images are not very high in quality, but by inserting an endoscope and the ultrasound transducer directly into the upper or lower digestive tract, it is possible to obtain high quality images of the organs.

Endoscopic ultrasound can be used to assess structures inside the body such as ovaries, uterus, liver, gallbladder, pancreas, aorta, etc.

EUS also can obtain information about the layers of the intestinal wall and adjacent areas such as lymph nodes and the blood vessels, as well as assisting in biopsies or the retrieval of foreign objects.

endoscopic ultrasound diagram Endoscopic Ultrasound EUS Thailand

EUS techniques are still being developed however it is currently being used for the following situations:

  • Staging of cancers of the esophagus, stomach, pancreas and rectum.
  • Evaluating chronic pancreatitis and other masses or cysts of the pancreas.
  • Studying bile duct abnormalities including stones in the bile duct or gallbladder, or bile duct, gallbladder, or liver tumors.
  • Studying the muscles of the lower rectum and anal canal in evaluating reasons for fecal incontinence.
  • Studying ‘submucosal lesions’ such as nodules or ‘bumps’ that may be hiding in the intestinal wall covered by normal appearing lining of the intestinal tract.

EUS can provide information regarding the depth of penetration of the cancer and spread of cancer to adjacent tissues and lymph nodes. This information is extremely useful for staging.

How to Prepare For EUS?

Your doctor will want to know your medical history; you should inform him of any allergies, other significant health problems such as heart disease, lung disease, diabetes.

You will be asked if you are allergic to iodine or shellfish as iodine containing contrast materials may be used.

Inform you doctor of any prescription or non-prescription medication you might be taking. Antibiotics are usually not required except in patients with certain heart valve problems.

If there is a possibility of fine needle aspiration (FNA), the doctor will want to check your blood for proper clotting. It is important to inform your doctor of any family history of bleeding problems or if you are taking medications that interfere with blood clotting (such as Coumadin) or platelet function (such as aspirin, Motrin, ibuprofen, Aleve, and other NSAIDs).

EUS is usually an out-patient procedure. You will be sedated an unable to work or drive for 24 hours, so you should arrange for someone to take you home afterwards.

You will be required to fast for at least six hours prior to the procedure. In case of a rectal EUS, you will probably need to take some enemas or laxatives.

EUS performed

Prior to your operation, the nurse or doctor will discuss with you the procedure and answer any questions. You will then be asked to sign a consent form declaring you fully understand the procedure, its alternatives and its risks.

You will then be placed on an IV drip which will be used to administer the sedatives and/or any other medication that is required.

Once sleepy, the EUS will be carried out. The entire procedure generally takes about 30-90 minutes (depending on the complexity), during which time you will only feel minimal discomfort, if any.

After the procedure you will be sleepy for up to one hour and be unable to drink or walk.

Once you are fully awake, the doctor will discuss with you the results of the procedure.

After talking with doctor you will be ready to go home. You will feel the sedative so should not drive home, organize a family member, partner or friend to take you home after the operation.

You may feel bloated from the insufflated air; this is only temporary and will resolve soon. Should your throat be mildly sore, for a day or two, salt-water will provide relief.

You should call your doctor if concerned about your progress or having severe pain, vomiting, passage or vomiting of blood, chills or fever.

If EUS was particularly difficult or complicated you may be kept in the hospital overnight. The endoscopist will discuss this with you, when you wake up.

Risks of EUS?

All surgical procedures carry an element of risk. Like other endoscopy techniques, endoscopic ultrasounds is safe and well tolerated.

The complication rate for EUS is less than two in two thousand.
Problems that can develop include reactions such as hives or skin rashes, and/or nausea from the medication used during the procedure. These symptoms usually resolve after time, however should they persist you should contact your physician as soon as possible.

Another serious complication is perforation (making a hole in the intestinal wall) that may need surgical repair. If fine needle aspiration is performed, complications occur slightly more often but are still uncommon at around 0.5-1.0%. If a needle is passed through the gut wall, minor bleeding may occur, if unusual bleeding occurs the patient may be hospitalizes briefly for observation.

Infection is another rare but serious complication. Infection can occur during aspiration of fluid from cysts and antibiotics may be given before the procedure.

If the FNA is performed on the pancreas, pancreatitis (inflammation of the pancreas) can rarely occur. Pancreatitis calls for hospitalization, observation, rest, IV fluid, and medication for abdominal pain. It usually resolves spontaneously in a few days.

Conditions Diagnosed with Endoscopic Ultrasound

EUS may be used to determine the cause of symptoms such as abdominal pain, to evaluate a growth (tumor), and to diagnose diseases of the digestive tract and lungs. Physicians use EUS to evaluate the following organs and problems:

    * Anal sphincter and incontinence
    * Barrett’s esophagus with high-grade dysplasia
    * Neuroendocrine tumors
    * Common bile duct stones
    * Gastric cancer/MALT lymphoma
    * Esophageal cancer
    * Lung cancer
    * Pancreatic cancer
    * Pancreatitis
    * Cystic neoplasms of the pancreas
    * Rectal cancer
    * Rectal fistulas
    * Smooth muscle tumors
    * Enlarged lymph nodes

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