EUS misconceptions

[Guest guest]

The difference between and ERCP and an EUS are quite large. The

ERCP is an actual look at the pancreatic ducts and anatomy, specific

treatment to the structures of the ducts can be done at that time,

and pressures can be taken and stints placed if necessary.

The ERCP is a scope that is passed through the mouth and is

specific as to what structures are viewed. It is possible to do

sphincterotomies during this proceedure if high pressures are noted

(manometery). It is also possible to remove any stones that could be

blocking pancreatic ducts. If SOD ( sphinter of Oddi dysfunction) is

diagnosed at this time, stints can be placed or ballon dilation can

also be completed.

An EUS is completed by passing a different type scope through

the mouth and ultrasound is part of the tip of this scope. Once in

the stomach ultrasound waves a used and pictures of the anatomy are

viewed on a screen like when a fetus is seen in utero. The stomach

not the pancreas is where the scope is placed. Then soundwaves are

used to view the anatomy of the abdomen. If a nerve block (celiac

plexus block) is to be completed at this time a very fine thin

needle is passed through the stomach and the branch of nerves that

lead to the pancreas ( celiac plexus) are then injected usually with

a topical anestheic (Marcaine) and a steroid (triamcinolone).

It is not possible to do a nerve block using an ERCP.

There is less danager of acute pancreatitis, because an EUS

never goes near the pancreatic anantomy. It is however possible to

irritate the nerves that innervate the pancreas, but if one has

pancreatitis those nerves are usually already irritated.

There are other celiac blocks that can be done, but they are

far more painful and traumatic, besides the fact that the patient is

not put to sleep.

I hope this clarification helps people make the right decision

from themselves. Knowledge is key to being an informed patient.

Atwell LPN