Eus (Endoscopic Ultrasound) Diagnosis and Biopsy Method

What Is EUS (Endoscopic Ultrasound)? Diagnosis, Biopsy, and Uses

Endoscopic ultrasound (EUS) is a minimally invasive diagnostic method that combines endoscopy and ultrasound technology in a single procedure to provide detailed imaging of digestive system organs.

It is used for diagnosing diseases of the pancreas, bile ducts, and stomach, as well as for biopsy procedures. Endoscopic ultrasound plays an important role in the diagnosis and staging of digestive system cancers. In some patients, fine needle aspiration biopsy (FNA) may be performed during the EUS procedure.

At Daviva Health Group, the EUS (Endoscopic Ultrasound) procedure is performed with advanced technological devices by experienced gastroenterology specialists.

What is EUS (Endoscopic Ultrasound)? Learn detailed information about the EUS procedure used in diagnosing diseases of the pancreas, bile ducts, and digestive system, biopsy methods, advantages, and risks.

What Is EUS (Endoscopic Ultrasound)?

Endoscopic ultrasound (EUS) is an advanced technique that combines endoscopy and ultrasound to obtain detailed and accurate analysis of diseases affecting the digestive system organs, including the esophagus, stomach, duodenum, pancreas, and bile ducts. It is one of the digestive system imaging methods.

Endoscopic ultrasonography combines endoscopy and ultrasound to obtain high-resolution images of the body's internal structures and makes an accurate diagnosis of many diseases possible.

It is performed in 2 forms as upper and lower digestive system endoscopic ultrasonography.

Upper digestive system endoscopic ultrasonography: It is performed through the mouth. The esophagus, stomach, pancreas, bile ducts, and duodenum, as well as lymph nodes, tumors, and cysts, are examined.

Lower digestive system endoscopic ultrasonography: It is performed through the anus. The rectum, anus, colon, and nearby organs such as the bladder and prostate, as well as lymph nodes and tumors, are examined.

During these procedures, mucosal biopsy may be performed and cytological samples may be taken using special needles. This is called fine needle aspiration biopsy (FNA).

Why Is EUS Performed?

Endoscopic ultrasound (EUS) is an advanced imaging method frequently used in the diagnosis of digestive system diseases. The question of which diseases EUS is used for is especially important in relation to pancreatic, bile duct, and digestive system cancers. By providing detailed imaging of the organs, this method helps ensure an accurate diagnosis.

Common uses include:

Evaluation of the pancreas Pancreatic EUS examination**, allows detailed assessment of unclear changes, cysts, tumors, or inflammatory diseases such as pancreatitis seen in the pancreas. Endoscopic ultrasound is a very important method in the early diagnosis of pancreatic diseases.

Bile ducts and biliary tract diseases To investigate the cause of bile duct obstruction, bile duct stones can be detected with EUS. In particular, small bile stones and bile duct strictures can be identified with a high degree of accuracy using the EUS method.

Evaluation and staging of tumors In digestive system cancers, the EUS procedure plays an important role in evaluating tumors of the esophagus, stomach, pancreas, and rectum. With this method, how far the tumor has spread into the intestinal wall and its spread to nearby lymph nodes can be examined in detail.

Rectal and anal diseases Endoscopic ultrasonography is very useful in the evaluation of rectal tumors, anal fistulas, and abscesses. Determining how deeply lesions extend into the intestinal wall plays an important role in treatment planning.

In Which Diseases Is EUS Used?

EUS can be used in the diagnosis of many diseases affecting the digestive system and adjacent organs:

• Pancreatic tumors and cysts
• Stomach and esophageal cancer
• Bile duct and gallbladder stones or tumors
• Lymph node enlargement and metastasis investigations
• Chronic pancreatitis and inflammatory conditions

Thanks to the EUS procedure, structures that cannot be seen with external ultrasound can be examined in detail and, when necessary, targeted biopsy can be taken.

What Are the Preparations Before EUS?

Endoscopic ultrasonography (EUS) is a diagnostic procedure. Since endoscopic ultrasound is performed under sedation, the patient can often be discharged the same day and return home. Before EUS, patients are advised to bring previous test results such as endoscopy, ultrasound, tomography, or MRI, and to inform the doctor about the medications they use.

If the upper digestive system (esophagus, stomach, duodenum, bile ducts, pancreas) will be evaluated with EUS, fasting for 6–8 hours is usually sufficient beforehand. The gastroenterology specialist will inform the patient in advance when to start fasting and whether regularly used medications should be taken on the day of the procedure.

If the lower digestive system (rectum, colon, and surrounding tissues) is to be examined, bowel preparation similar to colonoscopy is required.

If fine needle biopsy (FNA) is planned during the EUS procedure, coagulation tests may be performed to assess the risk of bleeding.

In some cases, especially when biopsy of pancreatic cysts or perirectal masses is planned, preventive antibiotics (prophylaxis) may be administered to reduce the risk of infection.

How Is the EUS Procedure Performed?

Endoscopic ultrasound (EUS), is an advanced imaging method used to examine the esophagus, stomach and duodenum, pancreas, and bile ducts in detail. In this procedure, a flexible endoscope with a camera and ultrasound probe at its tip is advanced through the mouth into the digestive system.

The endoscope is advanced into the stomach under direct visualization. A small amount of water may be given into the stomach to improve the transmission of ultrasound waves.

When necessary, a tissue sample (fine needle biopsy) can be taken from suspicious masses or lesions using a special ultrasound probe and a thin needle. This procedure helps establish a definitive diagnosis of the disease.

The EUS procedure usually takes 30–60 minutes. However, in some cases (for example, postoperative anatomical changes or emergencies), the procedure time may be longer.

After the procedure is completed, patients are usually rested under observation for 1–2 hours. Since sedation is used, driving, operating machinery, or making important decisions is not recommended for 24 hours after the procedure.

What Are the Advantages of the EUS Procedure?

Endoscopic ultrasound (EUS) not only provides high-resolution imaging but also allows some targeted interventional procedures to be performed. This feature may make the diagnosis and treatment process more effective.

The main advantages of EUS are as follows:

Targeted imaging: Lymph nodes and masses are examined in detail

Simultaneous diagnosis with biopsy: Imaging and tissue sampling can be performed in a single session

Minimally invasive: Does not require a surgical incision; risk and complications are low

Quick recovery: Allows a rapid return to daily life after the procedure

Cancer staging: Especially in pancreatic and esophageal cancer, diagnosis and staging can be performed at the same time.

What Are the Risks and Possible Complications of EUS?

Endoscopic ultrasound (EUS) is generally a safe procedure, and the risk of complications is quite low. However, as with any medical procedure, there may be some rare risks and possible complications.

The main risks are as follows: Allergic or hypersensitivity reactions may develop to the sedative medications used.

Mild bleeding may be seen, especially in cases where fine needle biopsy (FNA) is performed.

Rarely, changes in blood pressure, irregular pulse, or breathing problems may occur.

In very rare cases, the endoscope may cause irritation or injury to the digestive tract wall during the procedure.

It is a very rare complication. It may occur especially if the stomach or intestinal wall is already damaged.

For EUS to be performed comfortably and safely, it is important that it be carried out in fully equipped centers by doctors specialized in this field.

Frequently Asked Questions About EUS

What Is Fine Needle Aspiration Biopsy (EUS-FNA)?

If deemed necessary during EUS, an EUS biopsy procedure may be performed. This method is called fine needle aspiration biopsy (FNA). With this procedure performed under endoscopic ultrasound guidance, a tissue sample can be obtained with millimeter precision from a suspicious mass or lesion.

Fine needle biopsy with EUS is a minimally invasive method commonly used for the definitive diagnosis of pancreatic tumors, lymph nodes, and digestive system cancers. Because it can be performed during the same examination, a separate biopsy procedure is often not needed and the disease can be diagnosed more quickly.

Is the EUS procedure painful? The procedure is usually performed under sedation. If it is done for the upper digestive system, there may be mild throat or abdominal discomfort afterward.

How long does EUS take? It takes an average of 30–60 minutes. If sedation is used, 1–2 hours of observation at the hospital is required.

Which diseases does EUS evaluate? Pancreatic and esophageal cancer, stomach tumors, bile duct problems, lymph node enlargement, and chronic pancreatitis.

What is the recovery process after EUS like? Because it is a minimally invasive method, most patients can return home the same day. Mild discomfort may last for a few days.