Endoscopic Ultrasound


Endoscopic ultrasound (EUS) is a procedure used to obtain images and information about the digestive tract and the surrounding tissue and organs.

Download these instructions in .docx format (EUS Instructions).

Endoscopic ultrasound may be used to:

  • Evaluate mediastinal lymph nodes
  • Stage lung cancer
  • Stage esophageal cancer
  • Evaluate dysplastic barrettes
  • Evaluate sub epithelial lesions in the GI tract
  • Evaluate gastric cancer
  • Evaluate abnormal gastric folds
  • Evaluate pancreatic cysts
  • Evaluate pancreatic masses
  • Stage pancreatic and ampulla malignancy
  • Evaluate obstructive jaundice
  • Evaluate occult gallstone disease
  • Stage rectal cancer
  • Evaluate incontinence


Patient preparation

  • NPO solids minimum 6 hours and liquids 4 hours.
  • Colonoscopy prep ideal for rectal ultrasound evaluation minimum is flexible sigmoidoscopy prep (clear liquids and enemas.)
  • Oral medications can be continued the day of the procedure (taken with a small sip of water 6 hours before. Oral hypoglycemics should be withheld and insulin should be reduced by 1/2.
  • Aspirin can be continued.
  • Plavix (clopidogrel) should be discontinued for 7 days prior to procedure. Combination antiplatelet agents should also be discontinued for 7 days.
  • Coumadin low risk should be discontinued for 5 days for high risk bridge with Heparin.
  • Stop LMWH (low molecular weight heparin) 12 hours before procedure and unfractioned heparin for 6 hours.
  • All outside images must be loaded into PACS prior to patient arrival.


Note to physicians

Endoscopic ultrasound cannot be performed if:

  • Coagulopathy with INR > 1.5 and platelets < 50,000
  • Unacceptable risks for sedation
  • Altered anatomy such that the target of evaluation cannot be reached
  • Portal hypertension (limited data may pose complication risk and affect quality of needle aspirations)
  • Inability to provide informed consent
  • Pregnancy-relative contraindication



Call Winchester Gastroenterology Associates at 540.667.1244 to schedule an appointment or for more information. Please note: some patients will need to be seen in consultation prior to procedure to help maximize the procedural benefit.