Endoscopic Ultrasound
Endoscopic Ultrasound (EUS):
Combining endoscopy with ultrasound imaging to visualize the digestive tract and adjacent structures, aiding in the diagnosis and staging of GI cancers and evaluating pancreaticobiliary diseases.
Endoscopic ultrasound (EUS) is a specialized procedure performed at CIDS, offering precise imaging of the gastrointestinal tract (GIT) and surrounding structures. Unlike traditional endoscopy, which primarily visualizes the mucosal surface, EUS utilizes a flexible endoscope equipped with an ultrasound device to provide detailed visualization of deeper layers of the GIT, pancreas, bile duct, gallbladder, adrenal glands, and structures within the chest and abdomen.
EUS is typically conducted on an outpatient basis, with patients fasting for 6 to 8 hours prior to the procedure. It is performed under sedation monitored by an anaesthetist, ensuring patient comfort and safety. Diagnostic EUS procedures typically last 20-30 minutes, allowing patients to return home after 2-4 hours of observation. Interventional EUS, which may involve drainage procedures or therapeutic interventions, may require longer and may be performed as an inpatient procedure.
The main indications for diagnostic EUS include:
- Evaluation of pancreas disorders such as acute pancreatitis, chronic pancreatitis, pancreatic cysts, and pancreatic cancer.
- Assessment of bile duct diseases including stones and cancer.
- Identification and characterization of sub-epithelial abnormalities in the GIT.
- Accurate staging of various cancers including those of the esophagus, stomach, pancreas, bile duct, and ampulla.
- Diagnosis of mediastinal diseases such as lymph nodes and lung cancer through EUS-guided fine-needle aspiration (FNA) biopsy.
Interventional EUS procedures at CIDS include:
- Drainage of pancreatic fluid collections using stents.
- Biliary drainage procedures.
- Celiac plexus neurolysis for pain relief in advanced pancreatic cancer patients.
- Tumour ablations, particularly in the pancreas.
- Placement of markers for precise Image-Guided Radiotherapy (IGRT).
- Control of internal bleeding from ruptured veins using glue or coils.
EUS serves as a valuable tool for monitoring diseases and assessing treatment efficacy without radiation exposure. It is utilized for monitoring conditions such as pancreatic cysts, sub-epithelial GIT lesions, and regression of benign tumors following intervention.