EUS

Endoscopic Ultrasonography (EUS) is considered one of the most revolutionary and technically challenging imaging methods in modern gastroenterology. It is performed using a special endoscope (camera) with a high-frequency ultrasound probe at its tip. While gastroscopy or colonoscopy can only view the 'inner surface' (mucosa) of the organs, EUS allows millimetric visualization of the 'inside of the wall layers' of the stomach and intestine, and even deep surrounding organs like the pancreas, biliary tract, liver, and lymph nodes.

While traditional ultrasound, computed tomography (CT), or magnetic resonance (MR) devices image through the skin or from a distance, the view may not be clear enough because of air, fat, or bone tissue in between. In EUS, however, the ultrasound probe comes close enough to literally touch the organ being examined, for example the pancreas from directly inside the stomach. Since there is no barrier left in between, even very small masses, stones, or cysts measuring 1-2 millimeters can be detected with superior clarity.

The main difference EUS creates in clinical practice is that it goes beyond imaging and makes it possible to obtain microscopic tissue samples (biopsy). With this technique called 'Fine Needle Aspiration Biopsy (EUS-FNA/FNB)', cell samples are taken with extremely fine and safe needles from pancreatic masses, enlarged lymph nodes, or tumors within the stomach wall (submucosal) in deep regions that cannot be reached, or would be risky to reach, with tomography or ultrasound. In this way, a definitive cellular diagnosis is established without the need for major surgical operations.

EUS is the gold standard especially in the evaluation of pancreatic cancer or cysts. It stages how much a developing tumor has spread in the pancreas and whether it involves vital surrounding vessels, providing the surgeon with the most precise map as to whether an operation can be performed. At the same time, it is the only method to establish a diagnosis in cases of unexplained biliary tract dilations and suspected chronic pancreatitis.

Just like standard endoscopy, the procedure is completed painlessly under deep sedation, with the patient's comfort kept at the highest level.