1 / 34

An introduction to Endoscopic Ultrasound

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

suzy
Télécharger la présentation

An introduction to Endoscopic Ultrasound

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. An introduction toEndoscopic Ultrasound Dr Bernard Stacey Consultant Gastroenterologist Southampton

  2. EUS • Equipment • Technique • Indications • Normal anatomy • Staging cancers • Benign disease

  3. Equipment • Radial • Linear

  4. 7.5 and 12 MHz frequencies

  5. Technique • Preparation • As for normal upper GI endoscopy • Sedation • Alfentanyl and midazolam • Propofol • Antibiotic prophylaxis • Usual indications + biopsy / therapeutics

  6. 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

  7. Anatomy

  8. Anatomy

  9. EUS Superficial mucosa / balloon interface Lamina propria Submucosa Balloon Muscularis propria (T2) Adventitia

  10. Normal anatomy

  11. Normal anatomy

  12. Coeliac axis

  13. Splenic vein / portal vein confluence

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

  15. T1

  16. T2

  17. T3

  18. T4? Abutment echorich plane between tumour and vessel intact Adherence echorich plane partially/totally disrupted >3cm Invasion tumour compressing / growing into vessel lumen

  19. T4

  20. Coeliac nodes --> M1a disease

  21. Benign disease

  22. Gallstones missed on conventional USS Sludge

  23. 5mm 12mm

  24. GIST

  25. To EMR or not to EMR…?

More Related