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Tests and Treatments: Interventional Tests: Endoscopies: Endoscopic Ultrasound (EUS)

This page describes Endoscopic Ultrasound (EUS). It explains how to prepare, what to expect, and what to do afterwards. It reviews the risks. We want you to be as comfortable as possible with the test.

These guidelines apply to having your EUS on an out-patient basis. The arrangements are slightly different when the examination is given to patients who are already in hospital for other reasons.

What is Endoscopic Ultrasound?

Endoscopy is a procedure that looks at your digestive system from the inside using a flexible telescope and camera. It can be done either through your mouth (upper endoscopy), or through the rectum (colonoscopy). Endoscopic ultrasound is an extension of these techniques. The endoscope has a tiny sound transmitter in the tip which (through reflections like radar) can produce pictures of the tissues outside the intestine. The principle is the same as regular ultrasound scanning, but EUS provides greater detail since the instrument can get very close to the places of interest.

How Do I Prepare?

  • Make sure you understand what is being recommended and what is involved.
  • Tell your doctor if you:
    • have any allergies, heart or lung problems
    • are or think you may be pregnant
    • have had endoscopy in the past and if you had problems with the medicines
    • take antibiotics before having dental work
    • take medicine to thin your blood (e.g.Coumadin or aspirin compounds). They may need to be stopped for a few days
    • are a diabetic. You will probably need to adjust your insulin or pills.
  • Do not eat or drink for 6 hours before your test. Your stomach must be empty (but you can take blood pressure and heart medicines as usual the morning of your test, with a few sips of water). Do not take any antacids.
  • If the EUS exam involves the rectum, you will be given instructions about preparing the bowel.
  • Bring with you:
    • all prescription and over-the-counter medicines you are taking.
    • medical records that relate to your current problem.
  • Make sure an adult can take you home. The medicines used during the procedure will not wear off for several hours. You will NOT be able to drive. If you travel by public transportation, you will still need an adult to ride home with you.

If you come alone, your test will have to be rescheduled.

What Will Happen?

  1. The nurse and doctor will talk to you about the test and answer any questions you have. You should know why you are having an endoscopic ultrasound and understand the treatment options and possible risks. You will be asked to sign a consent form, which gives the doctor your permission to do the test, and any necessary treatment.
  2. You will put on a hospital gown. You will be asked to remove any eye glasses, contact lenses or dentures. An IV will be started and blood may be drawn for lab studies. You may receive antibiotics through the IV at this time.
  3. You will be taken by stretcher to the procedure room. The nurse will help you get into the correct position, usually on your side, and make you comfortable. A clip on your finger and cuff on your arm will help the nurse monitor your pulse, blood pressure and oxygen level.
  4. A medicine will be sprayed onto the back of your throat to make it numb. The medicine may taste unpleasant but it will stop any coughing or gagging during the test.
  5. You will be given medicine through the IV to make you relaxed and sleepy.
  6. A plastic guard will be placed between your teeth to protect them.
  7. When you are sleepy, the doctor will place a thin, flexible tube (endoscope) through the mouth guard and into your mouth.
  8. The doctor will then ask you to swallow. When you swallow, the endoscope will gently move down your esophagus, the same way food goes down when you are eating. You may feel like gagging, but you should not feel any pain. The endoscope will not interfere with your breathing.
  9. The doctor will guide the endoscope through your stomach and into your small intestine. This will allow the doctor to see the lining of your upper digestive system and treat any problems that may be found. The doctor will remove the endoscope slowly.
  10. Sometimes the EUS exam involves passing the endoscope into the rectum.
  11. The EUS will last 30-90 minutes.

Additional Tests and Treatments

  • Fine needle aspiration biopsy (FNAB). The EUS instrument can be used to direct a tiny needle into any area of concern, to take a sample of tissue for analysis in the laboratory.
  • The same needle can be used to inject medicines into diseased areas, and to help other types of treatment, such as removal of large polyps or drainage of local cysts or abscesses.

What Will Happen Afterwards?

  1. You will be taken on a stretcher to the recovery area to relax. Your blood pressure and heart rate are watched while you rest. You will be fully awake in about 30 minutes. Most patients leave in about one hour, but some stay for a few hours observation if specimens have been taken or treatments performed.
  2. After removing your IV, the nurse will give you written instructions to follow when you go home. If you have any questions, please ask. The doctor will talk to you about your test and treatments before your leave. You may have some cramping or bloating because of the air placed in your intestine during the examination. This should go away with the passage of gas (flatus).
  3. Even if you feel awake, your judgment and reflexes will be slow. You will not be allowed to leave unless an adult takes you home. You will NOT be able to drive.
  4. If treatments were done during your test, you may need to be observed overnight so the doctors can check on you.

For the Rest of the Day

  • You should rest quietly.
  • Do not drive, operate machinery, sign legal documents or make important decisions.
  • Do not drink alcohol or take sleeping or nerve pills.
  • Drink plenty of fluids. Return to your normal diet and medications unless otherwise instructed.
  • You may feel bloated and pass gas. This is normal and will go away in a few hours.
  • Your throat may be a little sore for a few days.

What are the Risks?

There are some drawbacks to EUS. Your doctor will discuss these with you, and answer your questions.

  • The test is not perfect. Occasionally, important lesions may not be seen, and treatment attempts may be unsuccessful.
  • The medicines may make you sick. You may have nausea, vomiting, hives, dry mouth, or a reddened face and neck.
  • A tender lump may form where the IV was placed. Call your doctor if redness, pain or swelling appears to be spreading.
  • Severe complications of Endoscopic Ultrasound and treatments are rare. These can include bleeding, or tearing (perforation) of the digestive system. If these happen, you will have to stay in the hospital, and surgery may be needed.
  • Fatal complications are extremely rare.

Call your Doctor if You

  • have severe pain.
  • vomit.
  • pass or vomit blood.
  • have chills and fever above 101 degrees.
Page last updated 04/09/2007 .