Understanding Endoscopic Ultrasound (EUS)

Advanced Diagnosis & Treatment for Digestive Diseases

Dr. Mohamed Bilal Azam
Consultant Gastroenterologist – EUS & Therapeutic Endoscopy
Dr. Rela Institute & Medical Centre

What is Endoscopic Ultrasound (EUS)?

Endoscopic Ultrasound (EUS) is an advanced medical procedure that combines:

Endoscopy – a flexible tube with a camera inserted through the mouth
Ultrasound – sound waves that create detailed images of internal organs

This allows doctors to see *very detailed images of the digestive tract and nearby organs from inside the body*.

Unlike regular scans, EUS can closely examine:

• Pancreas
• Bile ducts
• Liver
• Gallbladder
• Lymph nodes
• Digestive tract wall

EUS also allows doctors to *perform procedures and biopsies during the same examination*.

Why is EUS Done?

Your doctor may recommend EUS to diagnose or treat conditions involving the digestive system.

Common reasons include

• Evaluation of pancreatic diseases
• Detecting tumors or cancers
• Investigating unexplained abdominal pain
• Checking bile duct blockage or jaundice
• Evaluating gallstones or bile duct stones
• Assessing liver diseases
• Investigating digestive tract swelling or lumps

Organs That Can Be Examined with EUS

EUS can evaluate several organs located near the digestive tract.

• Pancreas
• Bile duct
• Gallbladder
• Liver
• Stomach and duodenum
• Lymph nodes around the abdomen

This makes EUS one of the *most precise tools for diagnosing abdominal diseases*.

Procedures That Can Be Done Using EUS

EUS is not only a diagnostic test—it can also treat several conditions.

1. EUS-Guided Biopsy (FNA/FNB)

A small needle is used to obtain tissue samples from:

• Pancreatic masses
• Liver lesions
• Lymph nodes
• Other abdominal tumors

This helps confirm diagnosis without surgery.

2. EUS-Guided Biliary Drainage

Used when bile ducts are blocked and ERCP cannot be performed.

Example:
Bile duct obstruction due to pancreatic cancer

A stent can be placed to relieve jaundice and restore bile flow.

3. EUS-Guided Choledochoduodenostomy

A minimally invasive procedure to create a passage between:

• Bile duct
• Duodenum

This allows bile to drain internally using a metal stent.

4. EUS-Guided Pancreatic Interventions

EUS helps manage:

• Pancreatic tumors
• Pancreatic cysts
• Pancreatic duct problems

5. EUS-Guided Liver Biopsy

EUS can safely obtain tissue samples from the liver through the stomach or intestine.

Benefits:

• Less pain
• More accurate sampling
• Access to both liver lobes

Real Clinical Examples from Our Centre

At Dr. Rela Institute & Medical Centre, EUS is used to perform advanced procedures.

Case Example

A patient with pancreatic head cancer developed:

• Bile duct blockage (jaundice)
• Duodenal obstruction

Using EUS-guided techniques, doctors successfully performed:

• Biliary metal stent placement
• Duodenal stent placement

This relieved symptoms and restored digestive flow without major surgery.

Advantages of EUS

• Minimally invasive
• Highly accurate diagnosis
• Early detection of cancer
• Allows biopsy during the same procedure
• Can perform therapeutic procedures
• Faster recovery compared to surgery

What to Expect During the Procedure

• The procedure is usually done under sedation
• A flexible endoscope is passed through the mouth
• The test usually takes 30–60 minutes
• Most patients go home the same day

Is EUS Safe?

EUS is generally a very safe procedure when performed by trained specialists.

Complications are rare but may include:

• Bleeding
• Infection
• Pancreatitis (rare)

Your doctor will explain all risks before the procedure.

EUS Services Available

At Dr. Rela Institute & Medical Centre

• Diagnostic EUS
• EUS-guided biopsy (FNA/FNB)
• EUS biliary drainage
• EUS choledochoduodenostomy
• EUS pancreatic interventions
• EUS-guided liver biopsy

Consultation

Dr. Mohamed Bilal Azam
Consultant Gastroenterologist
Special interest in EUS & Advanced Endoscopic Interventions

Dr. Rela Institute & Medical Centre

Early diagnosis saves lives. Advanced endoscopy allows precise treatment with minimal discomfort.