Pediatric Endoscopic Ultrasound (EUS)

What is pediatric endoscopic ultrasound (EUS)?

An endoscopic ultrasound (EUS) is an imaging test that creates detailed pictures of the digestive tract. This system goes from the mouth to the large intestine. EUS combines two technologies:

• Endoscopy, which uses a long, thin, flexible tube with a light and camera (endoscope)

• Ultrasound, which uses high-frequency sound waves to create detailed images of the inside of the body

With EUS, we examine the inside of your child’s esophagus (food pipe), stomach, small intestine and large intestine. The scope has a tiny ultrasound device at the tip so doctors can view nearby organs, including the liver, gallbladder and pancreas. Your child will receive medicine that puts them in a sleep-like state (general anesthesia) for their comfort during the procedure.

What are the benefits of pediatric endoscopic ultrasound (EUS)?

The main benefits of a pediatric endoscopic ultrasound include:

• Better images for diagnosing problems: EUS can often find problems that other imaging may not be able to find. That’s because the imaging is done from inside the body instead of outside.

• Less invasive procedure for biopsy: With EUS, doctors can use a small needle to take tissue or fluid samples to examine in the lab to diagnose diseases. Other biopsy methods require surgery to access the tissue for sampling.

Your child may benefit from an EUS if they have signs and symptoms of a gastrointestinal (GI) condition, also called digestive disorders. Our pediatric gastroenterologists (doctors who specialize in digestive disorders) use EUS to:

• Find the cause of abdominal (belly) pain

• Find the cause of abnormal weight loss or failure to thrive

• Diagnose gallbladder disease, pancreas disease and bile duct disease

• Take samples of tissue or fluid to examine in the lab (biopsy) to diagnose diseases

• Examine cysts, tumors and cancers

• Look for stones in the bile duct

• Drain pancreatic fluid collections or other fluid in the belly

What are the side effects of pediatric endoscopic ultrasound (EUS)?

Most of the time, children go through a pediatric EUS without any problems. Some children may have side effects, which can include:

• Bloating and discomfort due to gas

• Dehydration due to bowel prep

• Dizziness

• Fatigue (tiredness)

• Sore throat for a day or two

• Nausea and vomiting

What are the risks of pediatric endoscopic ultrasound (EUS)?

A pediatric endoscopic ultrasound is a safe and effective test, but it has certain risks, as does any procedure. Our doctor will discuss with you the possible risks for your child, which may include:

• Bleeding if a biopsy was done

• Infection

• Reaction to medications for anesthesia

• Tear (perforation) in a wall of the esophagus, stomach, intestines or other areas (very rare)

At Children's Health℠, your child’s health and safety are our highest priorities and we work carefully to minimize their risks.

What to expect with pediatric endoscopic ultrasound (EUS)

The procedures and their preparation are different, depending on whether your child is having an upper or lower endoscopy. Our care team works closely with you and your family to help you prepare for the EUS and your child’s recovery afterward.

What to expect before Pediatric Endoscopic Ultrasound (EUS)

Your child’s doctor or nurse practitioner will explain the procedure to you and answer your questions. Once your child’s EUS is scheduled, our scheduler will call you and send you a letter with the date of the procedure.

Our Child Life specialists are available to meet with your child before the procedure to help explain the procedure and put them at ease. Please ask your child’s care team to request a Child Life specialist.

If your child needs anesthesia for the EUS, the surgery department will call 2 days ahead. We will explain what time your child should stop drinking and eating before the procedure, and what time you should check in on the day of.

We will provide detailed instructions for preparing your child before the EUS and how to take care of them afterward. For a lower endoscopy (also called colonoscopy), your child will need to do bowel prep. You can download instructions in English or Spanish.

What to expect during Pediatric Endoscopic Ultrasound (EUS)

Your child’s care team will tell you what time you’ll need to arrive on the day of the procedure so we can prepare your child. Our pediatric anesthesiologist will give your child medicine for general anesthesia, which puts them in a sleep-like state and helps them feel no pain during the procedure.

During the EUS, the gastroenterologist will insert an endoscope through your child’s mouth for an upper endoscopy or through their anus for a lower endoscopy. The doctor carefully guides the scope to look for swelling, growths and other problems.

What to expect after Pediatric Endoscopic Ultrasound (EUS)

After the EUS, a nurse will take your child to the post-anesthesia care unit (PACU, also called the wake-up room). As the anesthesia wears off, the nurse may give your child clear liquids.

Your child's doctor will speak with you about how the procedure went, then you can join your child in the wake-up room. Our care team will provide complete instructions on how to care for your child at home, including recommended foods and a time frame for resuming their daily activities. You can take them home usually after about one hour in the wake-up room.

If we did another test or treatment during the EUS, the results usually take about 7 days to come back. Your child’s care team will call you with the results.

What questions should I ask my provider about pediatric endoscopic ultrasound (EUS)?

Find out more about pediatric EUS by asking your care team these questions:

• Are there other test options for my child?

• Will my child need to spend the night at the hospital after pediatric endoscopic ultrasound (EUS)?

• What medications should my child stop taking before pediatric endoscopic ultrasound (EUS), and when?

• How soon will I be able to see my child after pediatric endoscopic ultrasound (EUS)?

• Will my child go home with any special equipment after pediatric endoscopic ultrasound (EUS)?