An endoscopic ultrasound (EUS) combines ultrasound and endoscopy to look at the areas around your food pipe.
Endoscopy is a test to look inside your body. Your doctor uses a long flexible tube, called an endoscope, with a tiny camera and light on the end. They attach an ultrasound probe to the endoscope to do the test.
An ultrasound scan uses high frequency sound waves to create a picture of the inside of your body.
Why you have it
An endoscopic ultrasound helps doctors to check whether mesothelioma has spread into the lymph nodes close to the food pipe (oesophagus) and the centre of your chest. They can also take tissue samples (biopsies) of any enlarged lymph nodes or pleural tissue that looks abnormal.
Preparing for your test
You might have a blood test 2 days beforehand to check how well your blood clots.
Tell your doctor if you're taking medicine that changes how your blood clots. This includes:
- arthritis medicines
- warfarin or heparin
- apixaban or rivaroxaban
Your doctor tells you if you need to stop taking any other medicines.
You can't eat for 6 to 8 hours before the test but you might be able to drink sips of water up to 2 hours before your appointment. Your doctor or nurse gives you written instructions about this beforehand.
Talk to your doctor if not eating could be a problem for you. For example, if you have diabetes.
Your doctor will explain what they are going to do and you’ll sign a consent form. This is a good time to ask any questions you might have.
How you have it
Usually you have an endoscopy in hospital as an outpatient. A doctor or a specialist nurse (endoscopist) does the test. A nurse stays with you when you have it. The test usually takes less than 30 minutes.
When you arrive at the clinic, the staff might ask you to take your upper clothing off and put on a hospital gown.
You might have the test while you're awake but you can choose to have a medicine to make you drowsy (a sedative).
An endoscopy is a test to look at your foodpipe, stomach and the first part of your bowel.
You may have this test if you have abnormal bleeding, lasting indigestion or difficulty in swallowing.
On the day of the test you should not eat or drink for at 6 hours beforehand.
Just before the test your doctor will spray the back of your throat to numb it. Or give you a sedative which will make you forget having the test.
A nurse puts a mouth guard into your mouth. Then they put a flexible tube called an endoscope into your mouth and down your throat.
This is uncomfortable and may make you gag. Concentrating on slow deep breathing helps.
On the end of the tube is a light and a camera, this sends pictures to a monitor. It also has a tool that can take samples of tissue.
Looking at the monitor they examine your foodpipe and then your stomach.
If they see any abnormal areas they will take a tissue sample –called a biopsy.
You won’t feel any pain and you will be able to breathe normally throughout.
Afterwards you need to rest for a while. Your throat maybe sore and you may feel bloated.
Having the test
You lie down on the couch and have an injection of the sedative. It takes a few minutes for you to become sleepy.
Then the endoscopist passes the endoscope down your throat into your food pipe.
The tube has an ultrasound probe. This uses sound waves to build up a picture so your doctor can measure the cancer and see whether it has spread into nearby tissues. They might also be able to see if nearby lymph nodes are swollen (enlarged).
The endoscopist might use a special needle passed out of the end of the endoscope to take biopsies.
After your endoscopy
You need to rest for a while after the test.
You can't eat or drink for about an hour, until the local anaesthetic throat spray wears off. You might not remember much about the test if you have had a sedative drug.
You should be able to go home the same day. You can't drive or drink alcohol for 24 hours after having a sedative. You need someone to take you home from hospital and stay with you during this time.
Getting your results
You should get your results within 1 to 2 weeks. The doctor who arranged your endoscopy gives them to you.
Waiting for results can make you anxious. You can ask your doctor or nurse how long it takes to get them. Contact the doctor who arranged the test if you haven't heard anything after a couple of weeks.
An endoscopy is a very safe procedure. But your nurse tells you who to contact if you have any problems afterwards. Your doctors make sure the benefits of having an endoscopy outweigh the possible risks.
The possible risks include:
A sore throat
You might have a sore throat for up to 24 hours. Contact the hospital if you have severe pain in your throat, chest or tummy (abdomen).
You might have bloating or mild discomfort for several hours after the test. This is due to the air that the endoscopist puts into the stomach during the test.
There is a risk of bleeding from the biopsy site. This is usually a small amount and stops on its own. In rare cases you may need to have a blood transfusion.
There is a risk of a small tear (perforation) in the food pipe, stomach or small bowel. This is rare but can be serious.
Fluid going into your lungs
There is a very small risk of fluid going into your lungs from your mouth during the test. Your nurse uses a tube to remove most of the fluid from your mouth to reduce this risk.
Shortness of breath
A reaction to the sedative can cause breathing difficulties but this is rare. Your nurse checks your oxygen levels during the test. You have oxygen through a tube that fits into your nose (nasal cannulae).