Endoscopic ultrasound in gastroenterology: from diagnosis to therapeutic implications

Abstract

Since its advent in 1980, the scope of endoscopic ultrasound (EUS) has grown to include a wide range of indications, and it is now being incorporated as an integral part of everyday practice in the field of gastroenterology. Its use is extending from an adjuvant imaging aid to utilization as a therapeutic tool for various gastrointestinal disorders. EUS was first used to visualize remote organs, such as the pancreas and abdominal lymph nodes. When fine needle aspiration was introduced, the indications for EUS expanded to include tissue sampling for diagnostic purposes. At the same time, the needle can be used to convey a potential therapy to the internal organs, allowing access to remote sites. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in the field of gastroenterology.

Keywords: Ablation; Drainage; Endoscopic ultrasound; Endoscopic ultrasound-guided fine needle aspiration; Gastroenterology; Immunohistochemistry; Injection.

Figure 1

Difference between conventional oblique view and forward-view endoscopic ultrasound. A: Oblique-view endoscopic ultrasound (EUS). Note the maximum angulation and the needle direction; B: Forward-view EUS. Note the greater angle of retroflexion compared with conventional EUS.

Figure 2

Endoscopic ultrasound-guided celiac plexus neurolysis. Red arrow: Celiac ganglion; Blue arrow: Endoscopic ultrasound needle transfixing the gastric wall.