What is an EUS?

An EUS (Endoscopic Ultrasound Scan) procedure allows the endoscopist to look clearly at your oesophagus (gullet), stomach, pancreas and bile ducts, depending on your underlying condition. The scan uses high frequency sound waves transmitted through the tip of an endoscope. The endoscope (a flexible tube with a small camera at the tip) is passed down the oesophagus and into the stomach and duodenum. A scan of the surrounding structures can then be carried. Although you may have had other scans done, EUS is a very accurate technique, which may identify information which cannot be seen on conventional scanning. This test usually takes about 30 – 40 minutes.

What else may be done during the procedure?

A small tissue sample (Fine Needle Aspiration / FNA) can be taken through the endoscope, this will be painless.

Before the procedure

To allow a clear view, the stomach and duodenum must be empty. You will therefore be asked not to have anything to eat or drink for at least six hours before the procedure. When you come to the department, the procedure will be explained and a doctor will ask you to sign a consent form to ensure you understand the test and any potential complications. Please tell the nurse or doctor if you have had any previous endoscopic examinations, or reactions to drugs or allergies. If you have any worries or questions at this stage don’t be afraid to ask, the staff will want you to be as relaxed as possible for the test and will not mind answering your queries. You may be asked to take off your shirt or jumper and to put on a hospital gown. It will also be necessary for you to remove any false teeth or contact lenses. Jewellery or metal objects should also be removed; they will be kept safely until after the examination.

After the procedure

When you return to recovery, you will feel sleepy. The nurse will advise you when you can eat and drink. The results of the test and any treatment given will be explained and you should be allowed to leave the same day.

Going home

I it is essential that a responsible adult comes to collect you. Once home, it is important to rest quietly for the remainder of the day. Sedation lasts longer than you think. You should not: drive a vehicle; operate machinery; drink alcohol; or sign legal documents. The effects of the test and sedation should have worn off by the next day when most patients are able to resume normal activities.

What are the risks and complications?

Fortunately, these procedures are safe and complications are rare. Potential serious complications include bleeding, perforation (making a hole in the lining of the GI tract) and infection. If you have any problems after the EUS which you feel may be related to the test, please inform your doctor or hospital staff at once. An operation may be necessary to treat a complication, but this is very rare. Again, please do not hesitate to discuss possible complications or risks with the endoscopist before the EUS.

What to expect after EUS

Sedation given during the procedure will make you less alert and sleepy. Do not make any major decisions or sign any legal documents on the day. Do not drive for 24 hours after the procedure or drink alcohol, and avoid any strenuous exercise for 48 hours. You may resume all other activities on the day of the procedure.

• Food and drink
Alcohol in combination with any sedation you may have received is more likely to make you much more sleepy that usual. If local anaesthetic was used in your throat, you should not eat or drink until normal sensation returns, usually within an hour of the procedure. A mildly sore throat is no cause for concern and should resolve within 48 hours. Normal food can be taken after the examination, though you may prefer light meals on the day of the examination.

• Pain
A mildly sore throat is not unusual and should resolve within 24 hours. It is not uncommon to experience some discomfort immediately following the procedure due to air in the stomach, this is usually mild and will soon pass. If pain develops later, consult your own doctor, contact the Endoscopy Unit or go to the Accident & Emergency Department of your local hospital (taking a copy of the EUS report with you).

• Medications
You may resume normal medications immediately after your EUS, however we may advise against taking certain blood-thinning or anti-inflammatory drugs for a defined period. Please ask if you are not sure if your medication will be safe to take with the sedation.

• Things to report to your doctor

• Severe pain or vomiting
• Passage or vomiting of blood
• Temperature greater than 38 degrees

If you have any worries please do not hesitate to contact either the Endoscopy Department, your own GP or go to the Accident & Emergency Department of your local hospital (taking a copy of the EUS report with you).