Endoscopic Ultrasound (cont.)
When is EUS useful?
Being a relatively new diagnostic tool the uses for
EUS are still being developed and, presently, it is
being utilized in some of the following situations:
- Staging of cancers of the esophagus, stomach,
pancreas and rectum.
- Staging of lung cancer.
- Evaluating chronic pancreatitis and other masses or
cysts of the pancreas.
- Studying bile duct abnormalities including stones in
the bile duct or gallbladder, or bile duct, gallbladder, or liver tumors.
- Studying the muscles of the lower rectum and anal
canal in evaluating reasons for fecal incontinence.
- Studying 'submucosal lesions' such as nodules or
'bumps' that may be hiding in the intestinal wall covered
by normal appearing lining of the intestinal tract.
Staging of cancer is becoming an important use of
EUS. The prognosis of a cancer victim is related to
the stage of the cancer at the time of cancer detection.
For example, early stage colon cancer refers to cancer
confined to the inner surface of the colon before it is
spread to adjacent tissues or distant organs. Therefore
early stage colon cancer can be completely resected with
good chances for cure. However, if cancer is detected at
later stages, the cancer tissues have already penetrated
the colon wall and invaded neighboring organs and lymph
nodes, or have spread to distant organs such as liver and
lungs. Complete surgical excision becomes highly unlikely.
EUS can provide information regarding the depth of
penetration of the cancer and spread of cancer to adjacent
tissues and lymph nodes, information useful for staging.
What is the preparation for EUS?
Your doctor will
want to know about your health status especially if you
have any allergies, other significant health problems such
as heart disease, lung disease, diabetes mellitus, etc.You
will also be inquired about allergies to iodine
or shellfish as, under certain circumstances, iodine containing
contrast material may be used. If there
is a possibility of fine needle aspiration (FNA), the doctor
will want to check your blood for proper clotting. It is
important to inform your doctor of any family history of
bleeding problems or if you are taking medications that
interfere with blood clotting (such as Coumadin) or
platelet function (such as aspirin, Motrin, ibuprofen,
Aleve, and other NSAIDs). The wisest is to inform you
doctor of any prescription or non-prescription medication
you might be taking. Antibiotics are usually not required
except in patients with certain heart valve problems.
EUS is performed with sedation so you will not be
able to return to work or to drive for 24 hours. It also
means that you will need someone to take you home as this
is usually an out-patient procedure.
You will need to have an empty stomach that means no
oral intake for 6 or more hours. In case of a rectal EUS
you will probably need to take some enemas or
laxatives. In either case, full instructions will be given
to you.
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