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 | EUS - Endoscopic Ultrasound |
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Technical Aspects
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Endoscopic Ultrasound is a combination of endoscopy and ultrasound.
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It is a fascinating ultrasound method in with a high diagnostic and therapeutic impact.
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Its development came up in the 1980ies with stiff rectal probes. The possibility to produce miniaturized ultrasound transducers with a longitudinal or a radial array of ultrasound elements provides the application to flexible endoscopes.
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Especially the longitudinal technique is difficult to learn because of the multiple and unusual anatomical sections of the organs and structures in the body.
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Only a longitudinal endoscopic ultrasound instrument offers the possibilty to control interventional EUS.
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When learning this method it is very important to define the anatomical landmarks properly to recognize the relationship between pathological lesions and normal anatomy
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Diagnostic Impact
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The high resolution of the ultrasound image depicts the wall of the gastrointestinal tract itself and visualizes the adjacent organs.
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The main indication is the staging of tumors in the gastrointestinal tract according to the TNM-classification.
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Ultrasound guided fine needle aspiration (EUS-FNA) provides cytologic or histologic specimen with high sensitivity and specifity.
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Therapeutic impact
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EUS-guided pseudocyst drainage.
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EUS-guided drainage of rectal abscesses.
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EUS-CPN (celiac plexus neurolysis) in patients with pain caused by pancreatic carcinoma or chronic pancreatitis.
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EUS-assisted mucosectomy.*
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Drainage or relief of cysts, abscesses and effusions.
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Drainage of the bile duct (EUS-Cholangiodrainage) not accessible via ERCP, because of tumor or gastric surgery (gastrectomy, Y-Roux anastomosis, B-II)*.
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EUS-guided tumor therapy (f.e. pancreatic carcinoma).*
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