Endoscopic Ultrasound (EUS) Procedure | Cincinnati Children's

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Endoscopic ultrasound is an endoscopy procedure using a special endoscope with ultrasound capability. It is used for the purpose of evaluating internal organs of the chest and abdomen, along with the lining of the gastrointestinal tract.

It can be used in children weighing more than 15 kilograms.

The flexible echoendoscope is passed through the mouth into the stomach and small intestine.

It can be used for diagnostic purposes to visualize adjacent organs, lymph nodes and blood vessels.

Here we see ultrasound images of the pancreas. Use of the echoendoscope allows for visualization of the pancreas within close approximation of the stomach wall particularly the tissue and ductal structures.

In addition, EUS procedures can obtain tissue from organs or abnormal tissue adjacent to the stomach or small intestine to assist in making a diagnosis.

In this example, a biopsy is obtained from the right lobe of the liver to assist with diagnosis in a patient with elevated liver enzymes.

In addition to biopsies, endoscopic ultrasound guidance can be used for drainage of pancreatic pseudocysts or walled-off pancreatic necrosis, along with other intra-abdominal fluid collections.

Here, a needle is passed through the stomach wall into a pancreatic pseudocyst, followed by a wire through the needle. The newly created cyst-gastrostomy tract is then dilated with a balloon.

Plastic stents are placed to keep this tract open and allow the cyst fluid to drain into the stomach. These will be removed in a few months when the pseudocyst has resolved.

A larger, lumen apposing metal stent may be used for walled off necrosis.
Cincinnati Children’s provides endoscopic ultrasound and other advanced endoscopic procedures to patients of all ages.

Description:
This medical animation illustrates the use of endoscopic ultrasound (EUS) at Cincinnati Children’s, to evaluate intra-abdominal organs and the lining of the gastrointestinal tract. EUS is an advanced endoscopy procedure that uses a flexible, lighted tube with ultrasound capability. The specialized echoendoscope can also be used to obtain biopsies of internal abdominal organs or masses, and perform endoscopic treatment of pancreatic and abdominal fluid collections.
Credits:
Media Lab at Cincinnati Children’s (@CincyKidsMedArt)
Media Lab Direction: Ken Tegtmeyer MD & Ryan A. Moore MD
Animation: Jeff Cimprich, Cat Musgrove, & Mathew Nelson (Cincinnati Children’s Media Lab)
Content Expertise: David Vitale, MD and Tom Lin, MD
Voice Over: Batul Kaj-Carbaidwala, MD