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RE: EUS

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I've been told by my GI that an EUS is gentler on the digestive

tract than an ERCP. I have had 2 EUS performed, and not suffered any

consequences for having them, yet every ERCP I have been admitted

with pancreatitis.

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I think the ERCP would be enough. My GI ordered an EUS and said it only shows

what is going on on the outside of the pancreas. He ordered an ERCP 2 weeks

later and found that I had a SOD.

Patty

Corydon, IN

> EUS

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> The GI doctor's office called this morning and said they had set up

> the EUS. It's scheduled for April 14. I just got off the phone with

> my husband, and he said, " No, way. " Since he does taxes, this is a

> bad date for him. I'm thinking I'll wait to see if the ERCP reveals

> anything, then cancel the EUS. There is no point in having the EUS,

> if the ERCP shows nothing or anything, right? If the ERCP shows

> nothing, the EUS won't pick it up, will it? Tammy

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Hi Tammy,

The EUS theoretically can be more sensitive than an ERCP. The

endoscopic ultrasound looks at the tissue of the pancreas

whereas the ERCP looks only at the ducts - for blockage,

strictures, stones, etc. The EUS may detect tissue changes that

suggest chronic pancreatitis, or can find pseudocysts, or detects

masses or lesions that do not show up on ERCP (if the

pseudocyst doesn't connect to a duct the dye won't flow into it

and if the mass or lesion doesn't impinge on the ducts it won't

be detected by ERCP). The drawback to EUS though is that it is

a relatively new procedure and not many endoscopists have this

specialized training for interpreting the sonagram, therefore

there is alot of interobserver disagreement - that is, what one will

call mild or moderate pancreatitis, another will call normal.

However, if the ERCP comes back normal, it may be helpful to

do the EUS. If the ERCP comes back diagnostic, then the EUS

may be superfulous - who knows?

But I am surprised that they are not being done at the same time,

usually they are because of the whole sedation issue.

Laurie

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