endosonografie

Endosonografie, often referred to as endoscopic ultrasound (EUS), is a diagnostic imaging modality that combines endoscopy with high-frequency ultrasound to visualize the layers of the gastrointestinal tract wall and surrounding organs. A flexible endoscope equipped with a miniature ultrasound transducer at its tip is advanced to the esophagus, stomach, duodenum, or rectum. Radial EUS provides a circular 360-degree view of the GI wall and adjacent structures, while linear EUS yields a side‑viewing image that facilitates real-time needle guidance for sampling or therapy.

Indications include evaluation and staging of pancreaticobiliary disease and GI tract cancers, assessment of submucosal or cystic lesions, investigation of mediastinal and abdominal lymph nodes, and guidance for therapeutic procedures such as EUS-guided fine-needle aspiration or biopsy (FNA/FNB), cyst drainage, and celiac plexus neurolysis.

Procedure and safety: EUS is usually performed under sedation or anesthesia by a trained gastroenterologist. Real-time ultrasound allows targeted tissue sampling through the GI wall while minimizing invasiveness compared with surgical biopsy. Complications are uncommon but can include pancreatitis, infection, bleeding, or perforation, and risk varies with the indication and needle use. Antibiotic prophylaxis is considered in selected cases.

Limitations and scope: access is operator‑dependent and limited by anatomy and equipment availability. Tissue characterization is improved with FNA/FNB but cannot replace histology in all settings. EUS findings are integrated with other imaging and clinical data to guide management and may reduce the need for more invasive procedures in certain diseases. Training in EUS is specialized and commonly provided within gastroenterology fellowship programs.