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An introduction to Endoscopic Ultrasound. Dr Bernard Stacey Consultant Gastroenterologist Southampton. EUS. Equipment Technique Indications Normal anatomy Staging cancers Benign disease. Equipment. Radial Linear. 7.5 and 12 MHz frequencies. Technique. Preparation

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an introduction to endoscopic ultrasound

An introduction toEndoscopic Ultrasound

Dr Bernard Stacey

Consultant Gastroenterologist

Southampton

slide2
EUS
  • Equipment
  • Technique
  • Indications
  • Normal anatomy
  • Staging cancers
  • Benign disease
equipment
Equipment
  • Radial
  • Linear
technique
Technique
  • Preparation
    • As for normal upper GI endoscopy
  • Sedation
    • Alfentanyl and midazolam
    • Propofol
  • Antibiotic prophylaxis
    • Usual indications + biopsy / therapeutics
indications
Indications
  • Staging cancers
    • Oesophageal, pancreatico-biliary
  • Confirming EMR potential
    • T1 disease, excluding sub-mucosal involvement
  • Diagnosis and follow up of benign lesions
    • GIST, lipoma, cysts
  • Investigating RUQ pain
  • Investigating pancreatitis
slide12

EUS

Superficial mucosa / balloon interface

Lamina propria

Submucosa

Balloon

Muscularis propria

(T2)

Adventitia

staging oesophageal cancer
Staging oesophageal cancer
  • Part of national guidelines in assessment of potential curable disease
  • Complementary with CT
  • T stage
  • N stage
  • (M stage)
slide22

T4?

Abutment

echorich plane between tumour and vessel intact

Adherence

echorich plane partially/totally disrupted >3cm

Invasion

tumour compressing / growing into vessel lumen

slide29

5mm

12mm