With the opening of its Endoscopic Ultrasound (EUS) Program, the Digestive Disease Institute at North Shore University Hospital and Long Island Jewish Medical Center is now able to offer world-class expertise in diagnostic and interventional endosonography right here on Long Island. The center is located at North Shore University Hospital, Sandra Atlas Bass Campus, 300 Community Drive, Manhasset, NY 11030.

Endoscopic Ultrasound is a unique gastrointestinal procedure. In this procedure, sound waves are used to search for lesions, tumors, and other abnormalities in your esophagus (the tube that carries food from your mouth to your stomach), your stomach, the duodenum (the first part of your small intestine), and large intestine.

A special instrument called an ultrasound probe is used to send sound waves through your body. The probe is attached to the tip of an endoscopy, a lighted tube that allows your doctor to look inside your digestive tract. The probe also receives signals as the sound waves bounce off your stomach walls. These signals are converted into pictures and displayed on a monitor in the operating room while your doctor performs the procedure.

The indications/uses for EUS include:

• Staging of esophageal and gastric cancers
• Evaluation of abnormalities of the gastrointestinal wall
• Evaluation of thickened gastric folds
• EUS assisted endoscopic mucosal resection (EMR) of Barrett's with high grade dysplasia, cancer in situ, and early gastric cancer
• Staging of suspected or proven lung cancer
• Evaluation/diagnosis of posterior mediastinal masses, cysts or lymph nodes
• Diagnosis and staging of pancreatic cancer and pancreatic endocrine tumors
• Evaluation and treatment of pancreatic abnormalities
• Staging of ampullary neoplasms
• Diagnosis and staging of cholangiocarcinoma
• Evaluation of suspected choledocholithiasis/minilithiasis
• Celiac plexus block and neurolysis
• Staging of biopsy proven rectal cancer
• Diagnosis of recurrent rectal cancer
• Investigation of unexplained perirectal masses
• Evaluation of anal sphincter muscles in patients with fecal incontinence
• Evaluation of fistulae in inflammatory bowel disease

What to expect

Before the examination you will be asked to sign a consent form to give your permission for the examination. After you have signed the form, you will need to put on a hospital gown and to remove your eyeglasses, contact lenses and dentures. The back of your throat will be numbed with a spray, and an intravenous (IV) line will be started in your arm.

During the examination you will be positioned on your left side or belly and the doctor will inject a medication into a vein in your arm to help you relax. Once relaxed, the doctor will pass the endoscopy through your mouth. A guard will be placed over your teeth and gums to protect them. Then the endoscopy will be passed into your esophagus and stomach.You will feel drowsy and comfortable. If you are asked to change position during the procedure, a nurse will assist you. It takes about an hour to complete. The results will be interpreted and a report will be sent to doctor.

After the examination, you will remain in the recovery area until the effects of the medications wear off. Your throat may feel numb and slightly sore after the procedure. You should not eat or drink anything until your "gag reflex" has returned and you can swallow normally. To test for your gag reflex, your nurse will swab the back of your throat with a cotton swab. You should restrict yourself to clear liquids for the rest of the day. You may also feel full or bloated after the exam. This is normal and should pass quickly, although it may last several hours.

Risks

You should call your doctor if you experience bleeding, fever or any pain.

Results

Your doctor will tell you the results of your test and if you should undergo any additional tests.

For further information, please contact Dr. Neeraj Kaushik at the Digestive Disease Institute of the Division of Gastroenterology at (516) 562-4281.