Introduction:

Upper gastrointestinal endoscopic ultrasound is an examination that allows direct viewing of the inside of the oesophagus, stomach and duodenum and ultrasound viewing of the inside of its wall and neighbouring structures (mediastinum, pancreatic area and billiary tract) by introducing a flexible tube through the mouth. Endoscopic ultrasounds are carried out using an endoscope tube with an ultrasound system in the tip; this permits normal endoscopic viewing and ultrasound viewing of the area.

Indications:

Local staging of benign and malignant tumours of the organs indicated in the above section. This involves the study of the depth of the tumour, the invasion or lack of invasion into neighbouring organs and whether the ganglia near the tumour are affected by it.

Early detection of possible recurrences of previously-treated tumours.

Endoscopy- and ultrasound-guided puncture to obtain material from lesions for microscopic study.

Preparation:

Preparation is the same as for gastroscopy. The subject must not eat or drink for at least six hours before the test, including water. If medication must be taken, it should be taken with a minimum amount of water and the specialist who is to carry out the test must be informed.

If the subject has a blood clotting alteration or is taking medication that affects blood clotting, this should be reported before the test is carried out, particularly if a puncture is to be performed to obtain material.

Technique:

The anaesthetist will put you to sleep for the examination and you will not feel a thing. Before you are put to sleep, we will place a plastic mouthpiece inside your mouth to protect your teeth. The examination is performed by introducing the apparatus through the mouth to study the area of the digestive tract that is of interest and, if necessary, by introducing other material through the endoscopic ultrasound itself. The duration of these examinations is very variable and depends on what we want to study. However, they generally last from at least 10-15 minutes to a maximum of 2 hours.

Recovery:

It is a good idea to come with a friend or member of your family. Once the examination is over, if anaesthesia was used, you will need to wait a while until you feel more awake and the anaesthetist discharges you from the endoscopy unit. You will need to wait for a few minutes before eating or drinking anything as this could cause you to choke or vomit because of the anaesthetics used. You should not drive or carry out activities that require concentration for the next 24 hours. You may experience some temporary discomfort after the examination such as a sore throat or abdominal pain due to gas retention. Most endoscopic ultrasounds are usually performed on outpatients.

Risks:

The most frequent risks are a mild, sore throat and abdominal pain, which are passing. Other, more serious risks, are bleeding and intestinal perforation, although these are very uncommon. Other more serious risks, such as cardiorespiratory arrest, are absolutely exceptional and occur in elderly patients in very serious or critical conditions. In all events, the patient must authorise the examination by signing an informed consent form.