Posted on October 24, 2001 at 10:00 a.m.

BIRMINGHAM, AL — A state-of-the-art diagnostic technology now offered by UAB gives patients with digestive ailments more accurate and comprehensive diagnoses and treatment options.

Endoscopic ultrasonography, or EUS, is used to visualize the digestive tract and adjacent organs. It joins the medical technique of endoscopy with the high frequency sound-wave technology known as ultrasound. The high-tech combination allows doctors to acquire and microscopically examine tissue in and around the digestive tract.

“This technique is so versatile it can be used for a variety of diagnoses,” said Mohamad Eloubeidi, M.D., assistant professor and director of endoscopic ultrasound within the division of gastroenterology and hepatology. Eloubeidi is one of only two physicians in Alabama performing these procedures.

“With this information, physicians can better determine the type of treatment a patient needs, whether it be surgery, radiation or chemotherapy,” he said.

EUS can be used to diagnose gallstones and stones in the bile ducts, the presence of chronic pancreatitis and provide more accurate diagnosis and staging of esophageal, gastric, pancreas, rectal and lung cancers. It can also be used to collect tissue samples and alleviate pain.

Like endoscopy, EUS uses a flexible tube called an endoscope. A camera located on the tip of the endoscope allows doctors to guide the tube through the esophagus or rectum. The procedure can explore internal organs in a way that is much less invasive and more cost-effective than exploratory surgery and biopsy.

However, EUS is unique in that the endoscope is also equipped with an ultrasound device. “While a regular endoscope allows doctors to visually explore and record the surface of the digestive tract, the ultrasound allows doctors to better visualize the full extent and nature of abnormalities below the surface and in surrounding organs,” Eloubeidi said. While performing an EUS, doctors are able to switch between camera and ultrasonic views on a monitor and record both views.

“Because the system we use allows us to visualize the gastrointestinal walls at very high resolutions, we can use EUS for the early detection of tumors and small lesions,” Eloubeidi said. “In addition, EUS can define the depth of tumor invasion, which allows for selection of the most appropriate, stage-specific treatment.”

EUS can also be used to guide a small needle through the tube in order to collect tissue samples for further testing and/or deliver medication to alleviate severe chronic abdominal pain associated with pancreatic cancer and chronic pancreatitis (inflammation of the pancreas).

Eloubeidi said the procedure, which is done on an outpatient basis with patients under conscious sedation, usually takes approximately 30 minutes for routine diagnostic procedures and up to 1 1/2 hours for more extensive investigations that require biopsy. When a biopsy is taken, a pathologist is called to the room to examine the tissue on-site and confirm the diagnosis. Most patients leave with a known diagnosis and a plan for the next step rather than waiting for several days to receive results of the biopsy.

“EUS provides a less costly, safer, noninvasive method of clinical management for these patients,” he concluded.