Endoscopic Ultrasound: Gastroenterology Associates Case Studies

By: GI Alliance


Endoscopic Ultrasound (EUS) is an outpatient, minimally invasive procedure whereby an endoscopic tube is inserted into the mouth (for an upper GI EUS) or the anus/rectum (for a lower GI EUS). The endoscopic tube is outfitted with an ultrasound device on the tip that provides imaging from the inside of a patient, as opposed to alternative imaging measures that come from the outside of a patient inward, like X-ray, CT or PET scans, and MRIs.

Two physicians at Gastroenterology Associates, Dr Neelima Reddy and Dr Walker McDonald, are specially trained to perform Endoscopic Ultrasound. Because they are the only two providers of this service outside of New Orleans, patients from all over south Louisiana and even southern Mississippi come to Gastroenterology Associates to have their EUS completed.

Not only is Gastroenterology Associates a specialty group practice for digestive health, it is housed in the Digestive Health Center with Louisiana Endoscopy Center, allowing seamless provision of services to all patients under one roof.

While mostly performed in a hospital setting, we are proud to be the only center to offer this procedure in a safe and convenient outpatient setting.

Since 2009, Dr Reddy and Dr McDonald have performed EUS with various presentations in their patients. A few of the cases for which an EUS was performed and the resulting diagnosis are shared below.

Case Study #1:

A 45 year old woman was noted to have an incidental pancreatic cyst in the head of the pancreas and sent for further evaluation by EUS. At EUS examination, the entire pancreas was examined. Like most cysts, the cyst in the head was a fluid collection and not a concern.

However during the EUS, an abnormal area was noted in the tail of the pancreas. It was found to be pancreatic cancer, confirmed by a biopsy. The results of the biopsy were obtained within minutes, even before completion of the procedure!

The patient had an uneventful surgery and recovered well, all due to the early diagnosis of cancer, well before any symptoms occurred. This is not true of all pancreatic cancers, as the course of the diagnosis and treatment depends on the location and the stage of the tumor at diagnosis.

Case Study #2:

A 55-year-old man was referred for EUS after 12 years of symptoms related to low blood sugars. He had to eat frequently or would pass out.

After extensive testing, he was found to have high levels of insulin. While a tumor producing insulin was suspected, it could not be detected by CT scan, PET scan, or other special scans. An endoscopic ultrasound examination of the pancreas revealed a large tumor that was biopsied during the procedure. The results were immediate and actually came back during the procedure. They confirmed the tumor to be a neuroendocrine tumor which produces excess insulin.

The patient did well after surgery to remove the tumor and recently returned, 7 years after surgery, for his routine colonoscopy.

Case Study #3:

A small rectal cancer, noted during colonoscopy, was determined to be in a superficial stage after an EUS was performed. The patient only underwent a minimal surgical procedure to remove the cancerous cells, rather than the more invasive and routine abdominal surgery.

Case Study #4:

Two patients presented with repeated attacks of pancreatitis (inflammation of the pancreas), but they had no obvious cause for their condition. Both patients were referred for EUS examination of the pancreas to find a potential cause of recurrent pancreatitis.

One patient was noted to have sludge or small stones in the gallbladder which had not been detected by routine ultrasound. These were removed in surgery in order to prevent further attacks of pancreatitis.

The other patient was determined to have a small tumor, noted in EUS and biopsied. That patient was subsequently sent for surgery to remove the tumor.

Endoscopic Ultrasound In Baton Rouge, Louisiana

For many patients suffering with abdominal pain or uncertain previous test results, the mental anguish can be even more difficult to endure than the physical pain. The arsenal of procedures, expert physicians, and state-of-the-art facilities available at Gastroenterology Associates enable many unanswered questions to come to resolution and to chart a course of action for treatment.

One such procedure is the Endoscopic Ultrasound (EUS)., EUS is the standard of care in the local staging of most digestive cancers, such as esophageal, stomach, pancreas, or rectal cancers. Numerous conclusive diagnoses have been made for patients via EUS at Gastroenterology Associates and resulted in positive outcomes.

If ongoing abdominal pain or problems that have yet to be identified are an issue for you, schedule a consult with Gastroenterology Associates. Our physicians will determine if EUS or other tests would be appropriate for you. They want to help their patients have the best digestive health and to see them get well.