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Endoscopic Ultrasound (EUS)

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Our Mission

The mission of The Center for Advanced Therapeutic Endoscopy (CATE) is to approach each patient as a unique individual as we use our broad experience, and state of the art technology to focus on the overall needs of the patient and his or her family.

Endoscopic Ultrasonography (EUS), or Endoscopic Ultrasound, allows us to examine your esophageal and stomach linings as well as the walls of your upper and lower gastrointestinal tract.  The upper tract consists of the esophagus, stomach and duodenum; the lower tract includes your colon and rectum.

Endoscopic Ultrasonography

Endoscopic Ultrasonography

EUS is also used to study other organs that are near the gastrointestinal tract, including the lungs, liver, gall bladder and pancreas. While many gastroenterologists perform endoscopy or colonoscopy, relatively few are trained in performing EUS procedures”.

We will use a thin, flexible tube called an endoscope that has a built-in tiny ultrasound probe (like that used to examine pregnant women, only miniaturized). We will pass the endoscope through your mouth or anus to the area to be examined. Then we will use the ultrasound to produce sound waves which create visual images of the digestive tract.

Why is EUS done?

EUS provides us with more information than other imaging tests by providing detailed images of your digestive tract. We can use EUS to diagnose certain conditions that may cause abdominal pain or abnormal weight loss.


EUS can be used to guide a needle to the area where the nerves which supply the pancreas originate, the celiac axis. Numbing or deadening these nerves with an injection of anesthetic or alcohol (celiac axis block or neurolysis) will reduce pain in most patients with pancreatic cancer and other diseases of the pancreas.

Why is EUS used for patients with cancer?

EUS helps us determine the extent of spread of certain cancers of the digestive and respiratory systems. EUS allows accurate assessment of the cancer’s depth and whether it has spread to adjacent lymph glands or nearby vital structures, such as major blood vessels. In some patients, EUS can be used to obtain a needle biopsy of a lump or lesion to help us determine the proper treatment.

How should I prepare for EUS?

For EUS of the upper gastrointestinal tract, you should have nothing to eat or drink, usually for six hours before the examination. Our office will notify you when to start this fasting and whether it is advisable to take your regular prescription medications.

For EUS of the rectum or colon, we will instruct you to either consume a colonic cleansing solution or to follow a clear liquid diet combined with laxatives or enemas prior to the examination. The procedure might have to be rescheduled if you don’t follow these instructions carefully.

What about my current medications or allergies?

You can take most medications as usual until the day of the EUS examination. Tell us about all medications that you’re taking and about any allergies you have. Anticoagulant medications (blood thinners such as warfarin or heparin) and clopidogrel may need to be adjusted before the procedure. Insulin also needs to be adjusted on the day of EUS. In general, you can safely take aspirin and non-steroidal anti-inflammatory medications (ibuprofen, naproxen, etc.) before an EUS examination. Check with us in advance regarding these recommendations.


If you have an allergy to latex, you should inform us prior to your test. Patients with latex allergies often require special equipment and may not be able to have a complete EUS examination.

Do I need to take antibiotics?

Antibiotics are not generally required before or after EUS examinations. However, we might prescribe antibiotics if you are having specialized EUS procedures, such as to drain a fluid collection or a cyst using EUS guidance.

Should I arrange for help after the examination?


What can I expect during EUS?

Procedures may vary, but for an EUS examination of the upper gastrointestinal tract, we usually spray your throat with a local anesthetic before the test begins. Most often you will receive sedatives intravenously to help you relax. You will most likely begin by lying on your left side. After you receive sedatives, we will pass the ultrasound endoscope through your mouth, esophagus and stomach into the duodenum. The instrument does not interfere with your ability to breathe. The actual examination generally takes less than 60 minutes. Many do not recall the procedure. Most patients consider it only slightly uncomfortable, and many fall asleep during it.

An EUS examination of the lower gastrointestinal tract can often be performed safely and comfortably without medications, but you’ll receive a sedative if the examination will be prolonged or if we examine a significant distance into the colon. Most EUS examinations of the rectum generally take less than 45 minutes. You should know that if a needle biopsy of a lesion or drainage of a cyst is performed during the EUS, then the procedure will be longer and may take up to two hours.

What happens after EUS?




What are the possible complications of EUS?

Although complications can occur, they are rare when our physicians perform the EUS examination. Bleeding might occur at a biopsy site, but it’s usually minimal and rarely requires follow-up. You might have a slight sore throat for a day or so. Nonprescription anesthetic type throat lozenges help soothe a sore throat.


The possibility of complications increases slightly if a needle biopsy is performed during the EUS examination, including an increased risk of pancreatitis or infection, but these are still very uncommon. These risks must be balanced against the potential benefits of the procedure and the risks of alternative approaches to the condition.