The Leeds Teaching Hospitals NHS Trust

Endoscopic Ultrasound

What is endoscopic ultrasound?

Endoscopic ultrasound (EUS) combines endoscopy and ultrasound to diagnose and treat a range of gastrointestinal problems.

Why you might need it

Endoscopic ultrasound can help your doctor to diagnose a number of different conditions. It is the most sensitive method of looking for tiny gallstones and chronic pancreatitis which may not have been picked up on other scans. It can also be used to help determine the causes of abnormal liver tests and upper abdominal pain.

In addition, it enables your doctor to biopsy and assess cysts or tumours in the pancreas and biliary tree, and lymph nodes in the chest and abdomen. Finally, if you have been diagnosed with cancer of the gullet, stomach or pancreas, it allows for accurate staging of these conditions to determine what is the best treatment for you.

Endoscopic ultrasound is generally used to:

  • clarify the nature of an abnormality identified through previous tests
  • investigate the gallbladder and/or enlarged bile ducts
  • look for other causes of abdominal pain which may have been missed on previous tests, particularly small gallstones or chronic pancreatitis
  • study enlarged lymph nodes
  • evaluate tumours or cysts in the pancreas
  • assess tumours of the oesophagus, stomach or pancreas

Who will do it?

Endoscopic ultrasound is undertaken at St James’s University Hospital by Dr Matthew Huggett, Dr Bharat Paranandi and Dr Mark Aldersley.

Before your treatment

It’s important that you let us know about any medications you’re on as you might need to stop taking drugs which cause blood thinning. For further information please visit Before your procedure.

Your referring consultant will discuss with you if they feel any further tests are needed, if there are any other treatment pathways to consider, or if you can be booked straight in for this procedure.

Preparing for your treatment

You shouldn't eat or drink anything for at least six hours before your test is due.

The procedure

A small ultrasound probe is built into the tip of the endoscope, allowing for close examination using fine high frequency ultrasound. The images obtained are often more accurate and detailed than those provided by traditional ultrasound or other scans. Because the instrument has a working channel, different sized instruments such as needles can be put through the channel to obtain tissue samples and carry out drainage procedures.

Performed under sedation, the procedure takes approximately 15 - 45 minutes depending on the complexity.


After the procedure you will be taken to recovery where you will stay for about an hour before being discharged home. You may feel a bit light-headed due to the sedative and you’ll need a friend or relative to accompany you home and stay with you overnight if you’re an outpatient. The results of the test will be given to you by your referring consultant in the clinic - biopsy results can take a week or more to come back.

Your consultant will talk to you about the possible risks and complications of having this procedure - complications are rare (in around only 1% of procedures) and most complications are recognised either during the procedure or during recovery.