Endoscopic Ultrasonography (EUS)

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Important! This exam requires that you have an empty stomach. You should not consume any food for 8 hrs before the procedure. Stop drinking all fluids (including clear liquids and water) 4 hrs before the exam (minimal sips are allowed only to take your usual medications). Avoid gum and hard candy.

Medications: If you take insulin or other diabetic medicines, dosage adjustments will be provided for you. Bring your insulin with you so that you can take it after the procedure if necessary. If you are on blood thinners such as Plavix, Coumadin, Eliquis, Xarelto, or any other medications that thin your blood, let us know at the time of scheduling because they may need to be held.  All other meds should be taken at their usual time with a few sips of water.

What is it and why do I need it?

EUS has a variety of clinical applications. It is most often used to carefully evaluate the pancreas for any signs of inflammation or cancer and to evaluate pancreatic cysts. Sometimes EUS is used to drain cysts. It is also used to biopsy concerning lesions in the abdomen that were identified by other imaging tests. Staging of various gastrointestinal cancers is also performed using EUS. Stones in the bile ducts, which may require further treatment, can also be identified. 

The risks  

You will be asked to sign a consent form at the time of the exam. The risks of EUS are low (under 1%), but do include bleeding, infection, perforation, tearing, aspiration, medication reactions and heart/lung problems.  There is also a small risk of pancreatitis if your pancreas is biopsied. Most cases of EUS-associated pancreatitis are mild, requiring only a short hospital stay. In rare circumstances, pancreatitis can be severe, and even lead to death. If you have concerns about these risks, please contact your physician before your procedure. You will also be able to discuss this with your physician at the time of the exam.

The procedure    

In the preparation area, you will be asked questions about your health history. Your procedure usually takes 30-90 minutes and you will be sedated for it. For lesions in the upper gastrointestinal tract, bile ducts and pancreas, the procedure will resemble an EGD.  For lesions in the rectum or lower colon, the procedure will resemble a flexible sigmoidoscopy or colonoscopy. Please refer to these exams as appropriate.  

After the procedure 

In the recovery unit, your physician will discuss the results with you and give you discharge instructions. You and your driver will remain there until your sedation has worn off to a satisfactory level.  Rarely, patients are admitted to the hospital for observation or if complications occur. After discharge, you may  resume your usual activities and diet and return to work the following day. However, you may not drive, make important decisions or operate machinery the rest of the day.  You must have someone at least 18 yrs old with you during the entire time from check-in through recovery and to drive you home after the exam (a taxi or bus is not an option).  A report will be sent to your referring physician. If any biopsies are taken, you will be contacted with the results.