Endoscopic ultrasound (EUS)

Digestive symptoms can be stressful, especially when tests don’t give clear answers. An endoscopic ultrasound (EUS) offers a closer look at the inside walls of the gastrointestinal (GI) tract when scans like CT or MRI tests may miss important details. A thin tube (endoscope) equipped with ultrasound technology is inserted and guided to the area of interest to capture highly detailed images. This helps your care team find problems earlier and choose the right treatment.

At Penn Medicine, our gastroenterologists pioneered the use of endoscopic ultrasound, helping set the standard for accurate detection and treatment of complex digestive conditions, including cancer. Whether you need an upper EUS (for the upper digestive tract) or a lower EUS (for the colon and rectum), our specially trained gastroenterologists perform advanced endoscopy procedures to support a clear diagnosis and guide your care.

The EUS procedure is used when you have symptoms that need further examination, or when other tests haven’t given clear answers. Gastrointestinal specialists often use EUS to evaluate masses in the esophagus, stomach, colon, or pancreas, and to check for gallstones. If you have unexplained pain, abnormal imaging results, or concerns about pancreatic or bile duct disease, EUS can help provide answers. It may also be used to determine the stage of gastrointestinal cancer, which is important for planning the best treatment.

EUS is usually performed as an outpatient procedure. You’ll be given medicine to help you relax and sleep, so you won’t feel pain or remember the exam. Your provider gently guides a thin ultrasound endoscope through your mouth for an upper EUS, or through the rectum for a lower EUS, depending on the area being checked. The endoscope camera and ultrasound capture detailed images that your care team watches on a screen. Most procedures take less than an hour.

After the procedure, you’ll rest in a recovery area until the sedation wears off. You may feel groggy for several hours, so you’ll need someone to drive you home. Plan to take it easy for the rest of the day and avoid driving or making important decisions. If you had an upper EUS, a mild sore throat can occur but usually improves within a few hours. Most people return to their normal diet and activities the next day. Your care team will share your initial results and discuss next steps.