EUShas made a splash in the medical world as a new method. EUSis an ultrasound device at the tip of the endoscope. In this way, organs that cannot be seen or are difficult to see with external ultrasound are better evaluated. The first of these is PANCREAS. The pancreas is a very difficult organ to see. It is difficult to see the pancreas on abdominal ultrasound due to intestinal gases. EUS can see the pancreas in great detail as it examines from inside the stomach and intestines, that is, from a distance of 3-5 cm.
Many diseases in the pancreas can be diagnosed with EUS and even in recent years. It can be treated, at least partially. Pancreatic cysts used to be mostly evaluated by tomography or MRI. However, with the introduction of EUS in recent years, these cysts can be evaluated very clearly, and even cysts that cannot be seen on tomography/MRI can be seen. With EUS, samples are taken from the cysts with a needle and it can be understood whether the cysts are benign or malignant. In the past, this type of examination could not be carried out widely. In pancreatic masses, biopsy can be taken with a fine needle to obtain information about whether there is a tumor or not. Sometimes, the tissue diagnosis required for chemotherapy in advanced pancreatic cancer cases can be achieved effortlessly with EUS.
Severe pain is observed in advanced pancreatic cancer cases. It is necessary to give morphine-like painkillers to these patients. These painkillers have many side effects. With "celiac ganglion blockade and neurolysis", a new application of EUS, pain is prevented by administering alcohol or anesthetic to the nerves of the pancreas. All these procedures can be performed on an outpatient basis.
Again, in pancreatic tumors, how far the patient's tumor has progressed and whether there is any obstacle to surgery can be shown with EUS. Sometimes, even advanced imaging methods, such as tomography and MRI, lag behind EUS. Apart from this, EUS also includes imaging studies in the esophagus, stomach and duodenum. It can also see and diagnose external pressure and formations under the surface. GIST, which has been diagnosed more frequently in recent years (Gastrointestinal stromal tumors)are a good example of these. These tumors originate from the muscle layer under the mucosa covering organs such as the stomach. Therefore, it is not possible to understand what is happening in a normal endoscopy. EUS shows which layer of the stomach these formations originate from, their internal structure, size and relationship with surrounding tissues. It even allows taking a biopsy when necessary. For this reason, EUS can save many patients from unnecessary surgeries.
Lymph nodes (glands) and masses in the rib cage are dangerous formations. In order to diagnose these, it is sometimes necessary to enter the rib cage and take a biopsy from there. These methods are laborious methods. Again, in recent years, biopsies have been successfully taken from these formations in the rib cage adjacent to the esophagus using EUS. These procedures can be easily performed on an outpatient basis.
EUS is widely used in the staging of esophageal and stomach cancers. EUScan see how much the tumor has spread in the stomach layers, the surrounding lymph nodes, and can show by biopsy whether these lymph nodes are benign or not.
Pancreatitis (inflammation of the pancreas gland) It is a very dangerous situation when it is severe. "Pseudocysts", an important complication of pancreatitis, are fluid-filled cysts formed within the pancreas. These cysts can sometimes reach sizes of 10-15 cm. These cysts need to be drained in some patients. In the past, these cysts were drained by the radiology department or surgery. However, since it came into contact with the external environment while being discharged outside, there was a risk of infection. Nowadays, pancreatic pseudocysts are evacuated to organs such as the stomach by EUS. This is a method that is more comfortable for the patient, closer to natural, and has less risk of infection.
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