What is an Endoscopic Ultrasound?

An endoscopic ultrasound (EUS) helps doctors treat diseases in and around the digestive tract. It combines two kinds of technology:

• Endoscopy, which uses a thin, flexible tube with a camera and a light on the end
• Ultrasound, which uses high-frequency sound waves to create detailed pictures of internal organs

EUS can find problems that other imaging tests may not be able to find. EUS is done by a pediatric gastroenterologist – a doctor who treats diseases of the digestive tract. Cincinnati Children’s is one of only a few pediatric hospitals that offer EUS.

Why Is Endoscopic Ultrasound Performed?

A doctor may order an EUS for many reasons.

Diagnosis and Testing

EUS can be used to:

• Help diagnose chronic pancreatitis (inflammation or scarring of the pancreas)
• Find stones or debris in bile ducts (small tubes that carry bile from the liver)
• Find tumors and lesions in the abdomen
• Remove tissue or fluid for testing in the lab – called a “biopsy”

Treatment

EUS can be used to:

• Drain pancreatic or other fluid collections in the abdomen

What Happens During an Endoscopic Ultrasound?

EUS takes place in the operating or procedure room under general anesthesia. It is usually an outpatient procedure.

The doctor will pass an endoscope (thin, flexible tube) through the mouth and guide it to the stomach and first part of the small intestine. If the doctor needs to see the lower digestive tract, he or she may pass the endoscope through the rectum instead.

EUS can look at areas outside of the digestive tract that other imaging tests do not see as well. The doctor can put the probe very close to the “area of interest” inside the body. This helps the doctor see well. Images of the child’s digestive tract and organs appear on a video screen.

Sometimes EUS is only used to see inside the body to understand what is going on. Other times, the doctor provides diagnosis or treatment by sliding tiny surgical tools through the endoscope.

If the EUS finds stones in the bile duct or pancreatic ducts, the doctor may decide to remove the stones. This is called endoscopic retrograde cholangiopancreatography (ERCP). Cincinnati Children’s is one of only a few pediatric medical centers in the country that offers ERCP.

EUS procedures can take 30 to 90 minutes. It can take longer if ERCP is performed. Afterward, the doctor will meet with the family to:

• Discuss findings and treatments that happened during the EUS
• Talk about next steps
• Answer questions

Endoscopic Ultrasound Recovery

Most children can eat and drink normally soon after recovering from the anesthesia. Most can go home the same day. If the EUS involved a test or treatment, the child will stay the night at the hospital. Examples include a liver biopsy or ERCP treatment.

EUS test results are available three to seven days after the procedure. A care team member will contact the family to talk about the results.