Endoscopic Ultrasound (EUS)

An endoscopic ultrasound is an advanced endoscopic procedure, where a flexible tube with a camera and ultrasound probe is passed through the mouth into the oesophagus, stomach, and the first part of the small intestine (duodenum). It allows the Gastroenterologist to obtain detailed images of the walls of the digestive tract and surrounding organs such as the pancreas, bile duct and lymph nodes. Biopsies and other interventions may be performed under ultrasound guidance.

Diagnostic EUS:

• Evaluate growths in the lining of the oesophagus, stomach or small bowel

• Evaluate pancreatic cysts and masses

• Evaluate bile duct strictures

Therapeutic EUS:

• Treatment of conditions requiring connections between the stomach/small bowel and close by organs

• Coeliac plexus neurolysis for pain relief in pancreatic cancer

An empty stomach is essential:

• You should have nothing solid to eat in the 6 hours leading up to your arrival time. You may drink ‘clear fluids’ only (e.g. water, cordial, clear fruit juice, black tea or coffee WITHOUT milk, soft drinks) until 2 hours prior to your arrival.

• After that you must remain strictly nil by mouth, apart from a sip of water to take important regular medications, but NOT diabetic or blood thinning medications.

People with diabetes, heart valve disease, cardiac pacemakers, on weight loss drugs (e.g. Ozempic, Wegovy, Mounjaro, Trulicity, Saxenda), or on blood thinning medication e.g. Apixaban, Rivaroxaban, Dabigatran, Warfarin, Clopidogrel, Ticagrelor, Prasugrel (except Aspirin), may require special arrangements, which should be discussed with your Gastroenterologist.

• Arrive at the Endoscopy Unit at the time you are advised. Do not bring any valuables.

• You will be admitted by a nurse. After which, your Gastroenterologist and the Anaesthetist will speak with you.

• Deep sedation is administered by an Anaesthetist prior to the procedure so that you remain comfortable.

• The procedure time generally takes around 30-45 minutes.

• After the procedure, you will be taken to the recovery area until the sedation wears off.

• Your Gastroenterologist will briefly inform you of the findings of your procedure and necessary, a follow-up appointment will be organised to discuss the results in detail.

• Due to the sedation, within the first 24 hours of the procedure, you must AVOID driving, travel alone on public transport or taxi/uber, operate machinery, sign legal documents or consume alcohol. An adult must accompany you home after the procedure and stay with you overnight.

• After 24 hours, you can return to work and resume normal activities.

• Patients undergoing therapeutic EUS may need require hospital admission for observation post procedure.

Although complications can occur with any endoscopic procedure, they are not common after diagnostic EUS. Complication rate may be higher for patients undergoing therapeutic EUS.

• Mild sore throat and abdominal discomfort are common post-procedure.

• More serious complications are very rare, including perforation, significant bleeding and infection. Surgery may be required to repair a perforation.

• While EUS is an accurate tool to assess the pancreas, bile duct and upper gastrointestinal tract, it is possible that small but significant lesions may be missed

Like all medical procedures, there is a remote chance that a significant complication can result in death, however this is extremely rare.