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Endoscopic Ultrasound

Endoscopic Ultrasound

ENDOSCOPIC ULTRASOUND

Endoscopic ultrasound is used to diagnose problems in your upper gastrointestinal tract. These problems may be associated with growths or obstructions in the ducts including the esophagus, stomach, duodenum, and adjacent organs (such as the pancreas).

PROCEDURE:

It involves passing a small tube (scope) over your tongue, down your gullet, into your stomach and duodenum. This is a flexible tube with a light, a small ultrasonic device, and a camera in its tip. Air is then put into your stomach allowing the endoscopist to carry out the examination.

BENEFITS OF THE PROCEDURE:

This procedure can help us to:

  • identify very small growths (less than 1cm)
  • identify gallstones
  • examine glands
  • obtain a biopsy (tissue sample)
  • establish whether you need surgery and best method for you

RISKS INVOLVED:

Complications are rare you should be aware of the following:

  1. Loose teeth, crowns, and bridgework can be dislodged.
  2. A small hole, called a perforation, can be made during the procedure (the risk is approximately one in 1000). This risk will be slightly raised if abnormality such as a narrowing or growth is encountered (one in 500). If therapeutic intervention (treatment) is performed stretching the narrowing, the possibility can be up to one in 10 procedures. You may need to stay in the hospital if it happens.
  3. Very frail and/or elderly patients can get pneumonia from stomach juices getting into the lung.
  4. The sedation (if given) can cause agitation, difficulty breathing (which can increase the risk of pneumonia) or respiratory arrest (though this is very rare).

ALTERNATIVES AVAILABLE:

A CT scan can be performed, but the investigation is less sensitive, and small lesions (less than 1cm) can be missed.

  • A barium meal can provide x-ray images of the gastro-intestinal tract, but a biopsy cannot be obtained.

Please tell us if you have any allergies

DURING THE PROCEDURE:

Before the procedure takes place, a nurse will show you to your cubicle and put on a hospital gown. After you have changed, you can then relax on your trolley until it is your turn to be examined.

Please tell a member of staff if you have any mobility problems as you may be required to roll from side to side on the trolley during the procedure.

Before the procedure you must remove the following as they can cause discomfort and will interfere with the instruments used:

  • Contact lens
  • Jewellery (including body piercing)
  • False teeth (you can keep these in until immediately before the procedure)

Hearing aids can be left in-situ throughout the procedure.

You will be attached to a monitor and given oxygen. You will then be asked to lie on your left side and a mouth guard will be placed in your mouth. This enables the scope to pass through. When the ultrasound scope is inserted in the appropriate position, ultrasound images will be generated. No radiation is involved. A nurse will remain with you to reassure you and to clear away any saliva from your mouth. During the examination, the endoscopist may take some biopsies (tissue samples). This is painless. To put you at ease you will be given intravenous analgesic (painkillers) and sedatives. The medicine will be given via a cannula (small tube) in your hand or arm. It will relax you and may make you drowsy but will not put you to sleep. You will be able to hear and respond to any instructions given to you.

You may want to bring something to read – don’t forget your reading glasses, as you will need to sign your consent form. We will give you a hospital gown to protect your own clothing so you do not need to bring anything to change into.

DURATION OF THE PROCEDURE:

The actual procedure takes about 30-45 minutes, but please be prepared to remain with us all morning or afternoon, depending on your appointment time.  If someone accompanied you they are welcome to stay or we can contact them later when you are ready to go home.

AFTER THE PROCEDURE:

Please remember the following points

  1. You will have to stay with us for one or two hours as the sedation will make you a little sleepy.
  2. You must be accompanied home by a responsible adult and have someone with you overnight.
  3. The effect of the sedative can last up to 36 hours so you must not drive, operate machinery, or drink alcohol during that time Endoscopic ultrasound.
  4. Polyps are removed or any biopsies taken,  notice a small amount of blood next time your bowels open. limit your general activity for a day or two.
  5. As soon as you are ready you will be offered tea or coffee.
  6. You may experience mild stomach cramps from the air that was introduced into your stomach during the procedure. This will soon disappear.
  7. A report will be sent to your referring doctor.

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