Inside Looking In

Endoscopic ultrasonography helps doctors spot hard-to-find health problems

SUNDAY, Oct. 7, 2001 (HealthDayNews) -- Most people think of ultrasound as a way to peer inside the body. But now, an updated version of the technology is giving doctors an internal look at otherwise undetectable health problems in such hard-to-see places as the stomach.

It's called endoscopic ultrasonography, and, as the name implies, the technique involves simply taking a standard medical device called an endoscope and fitting an ultrasound transducer at the end.

"It's basically a way of combining an endoscopic procedure with a radiological procedure," says Dr. Andrew Warner, chairman of the department of gastroenterology at the Lahey Clinic in Burlington, Mass.

"With an endoscopic procedure, you insert a lighted tube into the colon or the stomach or small bowel, and you can visualize what it looks like on a television screen," he says. With [endoscopic ultrasonography], you have an ultrasound device at the tip.

"Let's say you needed to look at a patient's pancreas. Without this, you'd have to look through the entire abdominal wall, and sound waves have to go through a lot of things to get to what you're looking at. But with this technique, you can really put the ultrasound right next to the organ," Warner says.

With patients under general sedation, doctors slip the device down, for instance, the esophagus into the stomach. Once inside, the view provided by the ultrasound can be invaluable in finding tumors and cysts and in helping doctors determine what action to take, Warner says.

Dr. Larry Miller, associate professor of medicine and head of the research endoscopy unit at Temple University in Philadelphia, says the technology is a great improvement over the previous standard method of imaging for detecting health problems.

"The CAT scan is what would regularly have been used, but it doesn't have high-enough resolution to tell what's going on," he says.

"With endoscope, we can place the ultrasound transducer very close to the target organ and eliminate the interference. We can see structures around the stomach, like the pancreas, the spleen and the liver," Miller says.

"Local staging is how we determine the nature of things like tumors and cysts and what to do once we detect them, and this is actually the best [technique] for that."

Before endoscopic ultrasonography, doctors would often need to perform surgery on a patient to take a biopsy of a growth, for example.

Warner says the technique, introduced about eight years ago, is becoming more widespread, particularly in such areas as cardiology and gastroenterology.

"And it's becoming the standard of care for the staging of cancers," he adds.

What To Do

The American College of Gastroenterology offers more information about many kinds of digestive disorders.

For more detailed information and an illustration of the gastro-intestinal system, visit Virtual Hospital: GI Endoscopy Atlas.

SOURCES: Interviews with Andrew Warner, M.D., chairman, department of gastroenterology, Lahey Clinic, Burlington, Mass.; Larry Miller, M.D., associate professor of medicine, and head of the research endoscopy unit, Temple University, Philadelphia; Temple University press release
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