Name of the Procedure:

Esophagoscopy, flexible, transoral; with endoscopic ultrasound examination (EUS)

Summary

An esophagoscopy with endoscopic ultrasound examination is a medical procedure where a flexible tube with a camera and ultrasound device is passed through the mouth to examine the esophagus. This helps doctors get detailed images of the esophagus and nearby structures.

Purpose

This procedure helps diagnose and evaluate esophageal conditions such as tumors, strictures, or other abnormalities. The goal is to get detailed images and possibly take tissue samples to aid in diagnosis and treatment planning.

Indications

• Difficulty swallowing (dysphagia)
• Persistent pain in the chest or upper abdomen
• Unexplained weight loss
• Chronic acid reflux (GERD)
• Suspicion of cancer or other esophageal diseases

Preparation

• Fast for at least 6-8 hours before the procedure.
• Adjust any medications as directed by your doctor.
• Undergo blood tests or imaging studies if recommended by your physician.

Procedure Description

1. The patient is sedated to ensure comfort.
2. A flexible endoscope equipped with an ultrasound device is inserted through the mouth and guided down the esophagus.
3. The camera provides visual images, while the ultrasound gives detailed pictures of the esophageal walls and surrounding tissues.
4. The doctor may take tissue samples (biopsies) if necessary.
5. The endoscope is then carefully removed.

Duration

The procedure typically takes 30-60 minutes.

Setting

The procedure is usually performed in a hospital or an outpatient clinic equipped with endoscopic facilities.

Personnel

• Gastroenterologist or specialist trained in endoscopic procedures
• Anesthesiologist or nurse anesthetist
• Endoscopy nurse or technician

Risks and Complications

• Sore throat or discomfort
• Bleeding, especially if a biopsy is taken
• Perforation or tear in the esophagus (rare)
• Reaction to sedation or anesthesia

Benefits

• Precise diagnosis of esophageal conditions
• High-resolution imaging and detailed evaluation of the esophagus and nearby structures
• Early detection and treatment planning for esophageal diseases

Recovery

• Observation for a few hours post-procedure.
• Avoid eating or drinking until the numbness from anesthesia wears off.
• Follow-up instructions include dietary restrictions and management of any side effects.
• Most patients can return to normal activities within 24 hours.

Alternatives

• Barium swallow test
• Traditional endoscopy without ultrasound
• CT or MRI scans

Pros and Cons of Alternatives:

• Barium swallow is less invasive but provides less detailed images.
• Traditional endoscopy is simpler but lacks the detailed imaging from ultrasound.
• CT and MRI scans provide good images but do not allow for immediate biopsy or direct visualization.

Patient Experience

During the procedure, the patient will be sedated and should not feel pain. Post-procedure, there might be a mild sore throat and drowsiness from the sedation. Any discomfort is usually mild and can be managed with over-the-counter pain relief.