Pediatric Endoscopic Ultrasound

Outline of upper body showing endoscope inserted through mouth to stomach.

What is EUS? 

An endoscopic ultrasound (EUS) is a test we do to look at the inside the rectum. It's commonly used to look for abnormal tracts in the rectum or for fluid-filled areas. EUS may also be used to help diagnose certain diseases or to drain cysts or abscesses.

EUS shows both ultrasound images and live video of the GI tract. During the test, a flexible tube called an endoscope (or scope) is used. At the end of the scope is a tiny video camera and light. The video camera sends live images to a monitor. The scope also contains a very small ultrasound device. This uses sound waves to create images and send them to a monitor.

A needle is passed through the scope. The needle can be used take a small sample of tissue for testing. This is called a biopsy. The needle can be used to take a sample of fluid. This is called fine-needle aspiration (FNA).  

Risks and possible complications

Risks and possible complications include the following:

  • Bleeding

  • Infection

  • A hole (perforation) in the digestive tract

  • Risks of sedation or anesthesia

How to prepare for the test

  • Tell your child's healthcare provider about all the medicines your child takes. This includes vitamins, herbs, and over-the-counter medicine. It also includes all prescribed medicines, such as any blood thinners like warfarin, clopidogrel, ibuprofen, or daily aspirin. Ask your healthcare provider if your hcild should stop taking some or all of them before the test.

  • Your child may be prescribed antibiotics to take before or after the test. This depends on the area being studied and what is done during the test. These medicines help prevent infection.

  • Help your child follow the instructions for preparing for the test to make sure results are accurate. Instructions may include:

    • If you’re having an EUS of the upper GI tract (esophagus, stomach, duodenum, pancreas, liver):

      • Don't eat or drink for 6 hours before the test.

    • If you’re having an EUS of the lower GI tract (rectum):

      • Before the test, do bowel prep as instructed to clean the rectum of stool. This may involve a clear liquid diet and using a laxative (liquid or pills) the night before the test. Or it may mean doing one or more enemas the morning of the test.

      • Don't let your child eat or drink for 6 hours before the test.

  • Arrive on time at the facility. Bring your child's identification and their health insurance card. Leave valuables at home. If you have them, bring X-rays or other test results with you.

Tell your healthcare provider

For your child's safety, tell the healthcare provider if your child:

  • Takes insulin. Their dose may need to be changed on the day of the test.

  • Is allergic to latex.

  • Has any other allergies.

  • Is taking blood thinners.

During the test

An endoscopic ultrasound usually takes place in a hospital. The procedure itself may take 1 to 2 hours. Your child will likely go home soon afterward. During the test:

  • Your child will lie on their left side on an exam table.

  • An intravenous (IV) line will be put into a vein in your child's arm or hand. This line supplies fluids and medicines. To keep you comfortable during the test, your child will be given a sedative medicine. This medicine prevents discomfort and will make them sleepy.

  • If your child is having an EUS of the lower GI tract, they will be completely asleep under general anestehsia. The healthcare provider will gently put the flexible scope into the anus.

  • During the test, the scope sends live video and ultrasound images from inside your child's body to nearby monitors. These are used to examine the GI tract. Specialized procedures, such as drainage, are done as needed.

  • The healthcare provider may talk with you about the results soon after the test. Biopsy results take  several days.

  • In most cases, your child will be able to go home withing a few hours of the test.

After the test

Here is what to expect after the test:

  • Your child may feel tired from the sedative. This should wear off by the end of the day.

  • Your child can eat and drink normally as soon as the test is done.

When to call your child's provider

Call your child's provider if you notice any of the following:

  • Fever of 100.4° F ( 38.0° C) or higher, or as advised by your healthcare provider

  • Shortness of breath

  • Vomiting blood, blood in stool, or black stools

  • Coughing or hoarse voice that won’t go away

  • Worsening abdominal pain