What is Endoscopic Ultrasonography (EUS)?

Endoscopic Ultrasonography (EUS) combines the versatility of an endoscope with the high-frequency ultrasound probe at its tip to obtain detailed images of the gastrointestinal (GI) tract walls and the adjacent organs and structures (such as pancreas, bile ducts, mediastinum, lymph nodes). Because the ultrasound probe is placed inside the GI tract (rather than outside the body), it allows superior resolution, especially of deeper layers and adjacent structures. In modern practice, EUS is not only diagnostic, but also therapeutic: it can guide needle biopsies (fine-needle aspiration/biopsy), drain fluid collections, place stents, block nerves for pain relief, etc.

Why (and When) Do You Need EUS?

EUS is recommended in numerous clinical scenarios:

Key Indication:

• Detailed evaluation of masses or cysts in the pancreas (including early detection of pancreatic cancer) — EUS can detect very small lesions with high sensitivity.
• Assessment of bile duct and gall-bladder disease (e.g., dilated common bile duct of unknown cause) and stones/strictures in difficult locations.
• Staging of GI (oesophagus, stomach, duodenum, rectum) cancers: EUS helps determine how deeply the tumour invades the wall, whether nearby lymph nodes are involved, and if adjacent vessels are invaded — information that CT/MRI may miss.
• Evaluation of sub-epithelial lesions (those beneath the inner lining of the GI tract), e.g., gastrointestinal stromal tumours (GISTs), leiomyomas, etc.
• Mediastinal lymph node sampling (via EUS) in the chest (e.g., for lung cancer staging) since the probe can reach nodes adjacent to the oesophagus/trachea.
• Drainage or intervention: EUS can guide internal drainage of fluid collections (peripancreatic, perirectal) and can help in pain relief procedures like celiac plexus block/neurolysis in chronic pancreatitis or pancreatic cancer.

When you especially consider it:

• If your imaging (CT/MRI/USG) shows a suspicious lesion in the pancreas/bile duct/liver/lymph nodes. And you need higher detail.
• If you have an unexplained dilated bile duct, obstructive jaundice of uncertain reason, or suspected early pancreatic disease.
• If you have GI wall abnormalities (e.g., found on endoscopy) that need further characterisation.
• If you’re being evaluated for GI cancer and need accurate local staging for treatment planning.
• If you have fluid collections or complications of pancreatitis, you may benefit from minimally invasive drainage instead of surgery.

How is the EUS Procedure Performed?

Here’s an overview of what patients can expect:

• Preparation: Usually requires fasting (for upper-EUS) and bowel preparation (for lower GI EUS via rectum/colon). Medications (especially blood thinners) may need to be adjusted.
• Sedation: The procedure is typically done under conscious sedation or, in some cases, deep sedation/anaesthesia for comfort.
• Procedure steps:
  • For upper GI EUS: the echo-endoscope is introduced via mouth → oesophagus → stomach → duodenum.
  • For lower GI EUS: the instrument may be introduced via rectum → colon (in selected cases).
  • Once in position, ultrasound waves generate real-time high-resolution images. The operator can then guide a fine needle (EUS-FNA or FNB) for tissue sampling if needed.
  • If required, therapeutic intervention (e.g., drainage, stent placement, nerve block) may be performed.
• Recovery: Most procedures are outpatient; after sedation, you’ll be monitored, and you’ll be able to go home the same day. Usual instructions include rest for the remainder of the day, avoid driving, etc. Slight sore throat (upper), or bloating/discomfort (lower) may occur.

Benefits of EUS – Why It Matters

• Superior imaging resolution & early detection: Because the ultrasound probe is placed so close to target organs, EUS can detect very small pancreatic masses (2-3 mm) and subtle changes which might be missed on CT/MRI.
• Accurate staging: Especially for GI cancers, helping tailor therapy (less invasive vs surgery) based on tumour depth, nodal involvement, vascular involvement
• Minimally invasive interventions: Many conditions that required open surgery earlier can now be managed via EUS-guided procedures (drainage, biopsy, stent placement), thereby reducing morbidity and hospital stay
• Less radiation, real-time guidance: Unlike CT (radiation) or MRI (contraindicated in some), EUS offers real-time imaging and intervention capability.

Risks & Limitations

• Overall, EUS is safe when performed by experienced endoscopists with proper sedation and monitoring.
• Potential risks include bleeding (especially after needle biopsy), infection, perforation of GI wall (rare), complications of sedation, and pancreatitis if the pancreatic duct is manipulated.
• Operator-dependence: The diagnostic accuracy of EUS (especially for sub-epithelial lesions) depends heavily on endoscopist skill, needle technique, etc.
• Some lesions may still require complementary imaging (CT/MRI) or surgical assessment; EUS is a powerful tool, but not always standalone.

Why Choose Our Centre for EUS in Delhi

• We have a dedicated advanced endoscopy suite equipped with the latest high-frequency echo-endoscopes and experienced GI endosonologists.
• Our team offers both diagnostic and therapeutic EUS, meaning you get comprehensive care under one roof — from lesion detection, staging, to minimal-invasive intervention.
• Post-procedure support includes fast follow-up of biopsy results, multidisciplinary review with GI oncology/hepatobiliary teams, and personalised management plans.
• Convenient location in Delhi/NCR, flexible scheduling, and transparent fee structure.
• Emphasis on patient comfort and safety: sedation protocols, monitored recovery, and aid for accompanying persons when needed.