Endosonography

Endosonography (Endoscopic Ultrasound or EUS) involves a variety of procedures used for both diagnostic and therapeutic purposes. The specific procedures vary depending on the clinical indication and the area of the gastrointestinal tract or adjacent structures being examined or treated.

Fine-Needle Aspiration (FNA) and Biopsy

• Procedure: EUS-guided FNA allows for the extraction of tissue or fluid from organs such as the pancreas, lymph nodes, or liver. This is used to diagnose conditions like cancers, cysts, or infections.
• Treatment Application: It is commonly used to diagnose pancreatic cancer, lymphoma, and submucosal tumors of the GI tract. EUS-FNA can also help determine the stage of cancer by sampling lymph nodes or other nearby structures.

Cyst Drainage

• Procedure: EUS can guide the placement of a stent or catheter to drain pancreatic pseudocysts, abscesses, or other fluid collections that have formed due to pancreatitis or other conditions.
• Treatment Application: By providing a minimally invasive method to drain fluid collections, EUS-guided drainage helps in reducing symptoms like pain, infection risk, and prevents the need for more invasive surgery.

Celiac Plexus Block/Neurolysis

• Procedure: EUS is used to inject a pain-relieving agent or a neurolytic substance (like alcohol) around the celiac plexus, a network of nerves near the pancreas and abdominal organs.
• Treatment Application: This technique is particularly useful for managing severe abdominal pain in patients with chronic pancreatitis or pancreatic cancer. It offers significant pain relief and improves quality of life.

EUS-Guided Biliary Drainage

• Procedure: When traditional ERCP fails or is not feasible, EUS can guide the drainage of bile ducts obstructed by stones, tumors, or strictures.
• Treatment Application: This is particularly valuable in cases of biliary obstruction due to cancer (like cholangiocarcinoma) or complications following gallbladder surgery.

Tumor Ablation

• Procedure: EUS can guide the delivery of ablative therapies, such as radiofrequency ablation (RFA), directly to tumors. This is used for the destruction of small tumors or metastases that are not amenable to surgery.
• Treatment Application: Primarily used for treating pancreatic tumors, neuroendocrine tumors, or small liver metastases that are not resectable.