Endosonography(EUS)

    Procedure details

  • Endosonogaphy is an advanced imaging and therapeutic technique which has revolutionized the management of patients suffering from pancreatobiliary disorders. Echoendoscope is a flexible tube and on its tip ultrasound transducer is placed for imaging organs close to GI tract. Due to its high sensitivity and resolution, EUS is better then transabdominal ultrasound in selected cases. EUS has the capability of imaging the entire pancreas, gall bladder, bile duct and ampullary region along with mediastinum for the presence or absence of suspected pathology. Patient is usually sedated and is performed on a day care basis. Although a safe and very effective technique EUS still has its own procedure related risks. Prior to procedure the gastroenterologist will discuss with the patient and their relatives the benefits, risks, alternatives and technical details of EUS. The patient is in left lateral position and the echoendoscope is passed under vision for examination. Depending on the indication the procedure may require 5 to 15 minutes.
  • Some Key Features :
  • 1. Sonography by Endoscopy is known as Endosonography , and is now available in Bhopal.
  • 2. Endosonography requires special skills of both Sonography and Endoscopy and Gastroenterologist doctor is trained in Endosonography.
  • 3. Dr. Tarun Bharadwaj is the Best acute pancreatitis doctor in Bhopal who has extensive experience in managing patients suffering from pancreas problems and pancreatitis.
  • 4. The state of art Endosonography facilities for pancreas disease are now available in Bhopal.

    Diagnostic indications of EUS

  • 1. Evaluation of biliary pain and suspected CBD stone
  • 2. Evaluation of dilated CBD and obstructive jaundice
  • 3. Evaluation of Liver metastasis and space occupying lesions of liver
  • 4. Evaluation of gall bladder polyps, stone and cancer.
  • 5. Evaluation of early chronic pancreatitis and recurrent acute pancreatitis
  • 6. Evaluation of peripancreatic fluid collections for location, size and feasibility of drainage.
  • 7. Evaluation of cysts in pancreas and masses (pancreas cancer)
  • 8. Evaluation of abdominal and mediatinal lymphadenopathy (benign or malignant lymph nodes)
  • 9. Evaluation of malignant ascites and thickened peritoneum.
  • 10. Evaluation of gastric fundal varices
  • 11. Staging of pancreatic malignancies,vascular involvement and feasibility of surgery.

    Therapeutic indications of EUS

  • 1. EUS guided FNAC from lymph nodes and masess for establishing diagnosis
  • 2. EUS guided drainage of peripancreatic fluid collections(Pancreatic pseudocysts in acute/chronic pancreatitis)
  • 3. EUS guided choledochoduodenostomy and hepatico-gastrostomy for palliation of advanced pancreato-biliary malignancies.
  • 4. EUS guided Rendezvous in case of failed ERCP
  • 5. EUS guided fundal varices Coiling for effective obliteration

DR. Tarun Bhardwaj