What is an EUS?

• This test allows us 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 end) is passed down the oesophagus and into the stomach and duodenum. A scan of the surrounding structures can then be carried out.
• A small tissue sample (Fine Needle Aspiration/FNA) can be taken through the endoscope, this will be painless.
• Although you may have had other scans done, endoscopic ultrasound is a very accurate technique, which may identify information which cannot be seen on conventional scanning.

Alternatives:

• Due to the unique information obtained from an EUS there are no real alternatives.

What are the risks of having an EUS?

• A sore throat after the examination is common and should resolve after a few hours.
• There is a small risk of damage to crowned teeth or dental bridgework.
• Complications include perforation or tear in the intestine or bleeding. These complications occur in less than 1 in 2000 examinations but may require urgent treatment or an operation.
• If required, a blood sample will be taken before your test to check your clotting levels.
• Endoscopic Ultrasound with biopsy (Fine Needle Aspiration) slightly raises the risk of infection. If required, antibiotics may be given to help prevent infection.
• Endoscopic Ultrasound with biopsy (Fine Needle Aspiration) also slightly raises the risk of perforation or bleeding, this may require urgent treatment or an operation.
• A reaction to the drugs used during the test may require you to stay in hospital.
• Inhalation of gastric contents can cause pneumonia which would require antibiotic treatment.

How do I prepare for the EUS?

• If you are a Diabetic or taking Warfarin, Aspirin or Clopidogrel tablets, please contact the Endoscopy Unit.
• If you require ambulance transport, please arrange this with your GP at least seven days before your appointment.
• If you take any prescription medication take them at the normal time
• To allow a clear view with the endoscope, the stomach and duodenum must be empty.
• Do not eat anything for six hours before your appointment time. You may drink water up to two hours before your appointment time.
• Before the procedure you will be seen by a qualified nurse and the Endoscopist and you will have the opportunity to discuss any problems or worries.
• You will be asked to sign a consent form indicating that you understand the nature and risks of the procedure. The consent form is a legal document, therefore please read it carefully.
• You will be asked to put on a hospital gown.
• Please bring your dressing gown and slippers with you.
• Jewellery or metal objects should also be removed because they can interfere with the x-rays. They will be kept safely until after the examination.
• Please leave all valuables at home.
   

What will happen during the EUS?

• Your test will be performed by a qualified endoscopist or a trainee endoscopist under direct supervision.
• A qualified nurse will remain with you throughout the procedure.
• You will be asked to remove any dentures or glasses.
• A plastic guard will be placed in your mouth to protect your teeth and the scope.
• You will be asked to lie on your left hand side and then given an injection to make you relaxed and sleepy. This is not a general anaesthetic and you will not be unconscious, but it is unlikely that you will remember much about the test.
• A clip will be lightly attached to your finger to record your pulse rate and level of oxygen and your blood pressure may also be monitored.
• You will be given oxygen into your nostrils.
• Once you are sleepy the endoscope (a flexible tube with a small scanning probe at the end) will be passed through your mouth and into your gullet. The doctor will scan the oesophagus (gullet), stomach, pancreas or bile duct depending on your underlying condition.
• Small tissue samples (biopsies) can be taken through the scope. These will be retained.
• The test will not interfere with your breathing.
• A video recording and photographs may be taken for your records and will only be seen by those involved in your care.
• The test takes about 30 - 40 minutes.

What will happen after the EUS?

• You will be allowed to rest quietly in the recovery area where a qualified nurse will observe you until the main effects of the injection have worn off.
• You will be advised when you can eat and drink.
• After an EUS, patients are usually allowed home but please arrange for a relative or friend to collect you directly from the ward to take you home. Please liaise with the ward staff to arrange collection time.
• You will not be fit to go home by public transport.
• Once home you should rest quietly for the rest of the day.
• You should arrange for someone to stay with you overnight following the procedure.
• The after effects of the injection make you sleepy and forgetful for 24 hours after the examination.

For 24 hours following the test you must not:

• Drive a vehicle
• Operate machinery
• Drink alcohol
• Sign any legal documents
• Be left alone to care for children

When will I know the results of the EUS?

• Sedation makes you forgetful, but the endoscopist or nurse, in the presence of your accompanying relative or friend, will discuss the results of the test with you, if you wish.
• A full report will be sent to your doctor.
• Before you are discharged you should be given clear details concerning follow-up arrangements.

If you have any further questions you should contact:

Freeman Hospital

• Endoscopy Unit (9.00 am - 4.30 pm) 0191 2231208
• Day Treatment Centre (Ward 21) 0191 2231294

RVI

• Endoscopy Unit (9.00 am - 4.30 pm) 0191 2825655

If you have any queries or require any further information out of these hours, please contact your GP or NHS Direct (0845 46 47).