Echoendoscopy is a technique that consists of joining a thin flexible tube (endoscope) with an ultrasound (ultrasound). This makes it possible to perform an ultrasonographic study of certain organs or lesions inside the human body.
What is endoscopic ultrasound?
During endoscopic ultrasound, the endoscope is introduced (through the oral cavity or anal orifice) to study and/or obtain samples of a certain organ or lesion, allowing us to get as close as possible to the organ in question. This requires the patient to be still and cooperate, so the procedure is performed under sedation of the subject.
Thus, echoendoscopy is performed mainly for two purposes:
- To study the state of a certain organ or lesion under the prism of ultrasound.
- To obtain material to analyze a certain organ or lesion: adenopathies, cysts, tumors.
Applications of endoscopic ultrasound
Echoendoscopy is indicated in the study of benign and malignant tumors located in the mediastinum (near the esophagus), pancreas, biliary tract and pelvic cavity. This technique is used to assess the size of the lesion, whether it affects neighboring organs or whether it affects lymph nodes adjacent to the tumor. In addition, by puncturing them with a fine needle, material can be obtained which, when analyzed by the pathologist, allows the tumor lineage to be identified. All this makes it possible to establish and agree on the best available treatment for the different lesions detected.
This technique, which must be performed by a specialist in the digestive tract, also allows the evaluation and characterization of lesions located below the mucosa of the digestive tract, as well as the evaluation of both the biliary tract (gallbladder and common bile duct) and the pancreatic tract.
Another application is the emptying of some cysts or abscesses close to the digestive tract.
Preparation of the patient for the echoendoscopy
If the procedure is to be performed under sedation, which is the most common, the patient needs to fast for at least 6 hours, as well as to follow the pharmacological indications prescribed by the anesthesiologist. The anesthesiologist will probably indicate that the patient needs to stop taking Synthrom or other anticoagulants, or aspirin or plavix or other antiplatelet agents. In this regard, especially if material is going to be obtained from a lesion, a coagulation study will be essential.
On the other hand, if the echoendoscopy is performed through the anal orifice, it will require a cleansing of the colon similar to that performed for a colonoscopy, but unlike the latter, it does not usually require sedation.
Risks of endoscopic ultrasound
Although it is an exploration with high levels of safety, occasionally some type of complication may occur, either due to sedation or due to the procedure.
The patient’s state of health is a determining factor in endoscopic ultrasound; it is not the same to perform the procedure on an 80-year-old COPD patient with ischemic heart disease as on a young patient with no personal history. For example, when obtaining material from a certain lesion or tumor, it can bleed, become infected or trigger pancreatitis after a pancreatic puncture. In general, the complication rate is less than 2-3% of procedures.