EUS - 超声内镜

EUS - Endoscopic Ultrasound

                               
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EUS (Endoscopic Ultrasonography)

What's EUS?

Endoscopists are experienced professionals who welcome a patient’s questions regarding their experience, training and experience. Endoscopist uses a thin, flexible tube called an endoscope that has a built-in small ultrasound probe. Physician will pass the endoscope via a patient’s mouth or anus towards the area to become examined. Physician then uses the ultrasound to make use of sound waves to create visual pictures of the digestive tract.

Endoscopic ultrasonography enables doctor to examine a patient’s esophageal and stomach linings as well as the walls of the upper and lower gastrointestinal tract. Top of the tract consists of the esophagus, stomach and duodenum; the lower tract includes patient’s colon and rectum. EUS is also accustomed to study other organs that are near the gastrointestinal tract, including the lungs, liver, gallbladder and pancreas.

Why is EUS employed for patients with cancer?

EUS helps a doctor to determine the level of spread of certain cancers of the digestive and respiratory systems. EUS allows doctor to accurately measure the cancer’s depth and whether or not this has spread to surrounding lymph glands or nearby essential structures, for example major arteries. In some patients, Endoscopic Ultrasound can be used to get you a needle biopsy of the lump or lesion to assist a doctor figure out the correct treatment.

Why is EUS done?

EUS provides a doctor with more information than other imaging tests by giving detailed pictures of patient’s digestive system. Doctor can use EUS to identify certain problems that could cause abdominal pain or abnormal weight loss.

Endoscopic Ultrasound can also be accustomed to assess known irregularities, including lumps or lesions that have been discovered in a prior endoscopy or were seen on x-ray tests, like a computed tomography scan. EUS supplies a detailed image of the lump or lesion, which can help a physician figure out its origin and help treatment decisions. EUS may be used to identify diseases from the pancreas, bile duct and gallbladder when other tests are inconclusive or conflicting.

How about a patient’s current medications or allergies?

A patient can take most medications as usual until the day's the EUS evaluation. A patient should tell his/her doctor about all medicines that he or she is taking contributing to any allergies they've. Anticoagulant medications and clopidogrel may need to be modified prior to the procedure. Insulin must also be modified at the time of EUS. Generally, patient can without danger take aspirin and non-steroidal anti-inflammatory medications (ibuprofen, naproxen, etc.) before an EUS evaluation. Seek advice from physician ahead of time regarding these recommendations.

Check with the doctor about which medicines a patient should consume the morning from the EUS examination, and take only vital medications with a small sip of water. If your patient comes with an allergy to latex, he/she should inform his/her physician prior to test. Patients with latex allergies often require special equipment and may be unable to have a complete EUS examination.

How should a patient get ready for EUS?

For Endoscopic Ultrasound from the upper gastrointestinal tract, someone should have nothing to eat or drink, normally for six hours before the examination. Patient’s doctor will inform him/her when to start this fasting and whether it is advisable to consider regular prescription drugs.

For Endoscopic Ultrasound of the rectum or colon, doctor will instruct patient either to ingest a colonic cleansing solution in order to consume a clear liquid diet coupled with laxatives or enemas prior to the evaluation. The process may need to be rescheduled if the patient doesn’t follow his/her doctor’s directions carefully.

Does someone need to take antibiotics?

Antibiotics aren't generally required before or after EUS examinations. However, doctor might prescribe antibiotics if a patient has specialized EUS procedures, for example to empty a fluid collection or perhaps a cyst using EUS guidance.

Should a patient request help after the examination?

If a patient received sedatives, he/she shalln’t be permitted to drive following the procedure, even when she or he does not feel tired. Patient should arrange a ride home in advance. Patient also needs to intend to have someone stay with him/her in his/her own home following the evaluation, because the sedatives could affect judgement and reflexes for the rest of the day.

What can someone expect during EUS?

Practices vary among physicians, however for an Endoscopic Ultrasound study of top of the gastrointestinal tract, some endoscopists spray patient’s throat with a local anesthetic prior to the test begins. Usually he/she will receive sedatives intravenously to help relax. Someone will most likely start by lying on his/her left side. Following a patient receives sedatives; his / her endoscopist will pass the ultrasound endoscope through patient’s mouth, esophagus and stomach into the duodenum. The device does not interfere with patient’s ability to breathe. The actual examination generally takes under 60 minutes. Many do not recall the procedure. Most patients contemplate it only slightly unpleasant, and several drift off during it.

An Endoscopic Ultrasound examination of the low gastrointestinal tract can often be performed securely and comfortably without medicines, but a patient will get a sedative when the examination will be prolonged or if the doctor will examine a substantial distance into the colon. Patient will start by lying on left side with his or her back toward a doctor. Most EUS examinations of the rectum generally take less than 45 minutes. Patient ought to know that if a needle biopsy of a lesion or drainage of the cyst is performed throughout the Endoscopic Ultrasound, then your procedure will be longer and could take up to two hours.

What goes on after EUS?

If a patient acquired sedatives, he/she will be supervised in the recovery area until the majority of the sedative medication’s effects have worn off. If a patient had a maximum EUS, his/her throat may be a little painful. Patient might feel bloated because of the air and water that were introduced during the evaluation.

Patient will be able to eat after leaving the procedure area, unless he or she is instructed otherwise. Doctor generally can inform patient’s of the preliminary results of the procedure that day, however the results of some tests, including biopsies, may take several days.

Do you know the possible complications of EUS?

Although complications can occur, they're rare when physicians with specialized training and experience perform the EUS examination. Bleeding might occur at a biopsy site, but it’s usually minimal and rarely requires follow-up. A patient might have a small a sore throat for any day or so. Nonprescription anesthetic type throat lozenges help soothe an aching throat. Other potential but uncommon risks of Endoscopic Ultrasound include a reaction to the sedatives used, aspiration of stomach contents into patients lungs, infection, and difficulties from heart or lung diseases. One major but very uncommon problem of EUS is perforation. This is a tear with the lining of the intestine that may need surgery to correct.

The possibility of difficulties increases slightly if a needle biopsy is conducted during the EUS evaluation, including an increased risk of pancreatitis or infection, these risks must be balanced from the potential benefits of the process and also the risks of alternative methods to the condition.