Endosonography is a gentle examination procedure that uses ultrasound to image specific organs from inside the body. The digestive organs and the thoracic cavity are particularly frequently examined using this relatively new method of diagnosis. The advantages of endosonography include freedom from radiation, close proximity to the organ being examined, and the ability to perform biopsies or therapeutic interventions at the same time.
What is endosonography?
Endosonography is an ultrasound that is not performed as a classic variant by moving the transducer on the skin, but provides the images directly from inside the body. Endosonography is an ultrasound that is not performed as a classic variant by moving the transducer on the skin, but provides images directly from inside the body. This is possible with the help of rigid or flexible endoscopes, which can be inserted by the examiner directly into the organ systems to be examined or into nearby body orifices. At the tip of the endoscope is a small ultrasound probe, which can be used to obtain particularly informative images, as it is ideally located directly on the tissue to be assessed, such as the mucosa of the stomach or intestine. As with the classic sonography method, the recorded events inside the body can also be followed in parallel on the screen during endosonography. This is particularly useful when the ultrasound from inside the body is not only used to detect inflammations, constrictions or tumors, for example, but also to perform punctures from the tissue in parallel under visual control to round off the diagnosis.
Function, effect and goals
Endoscopic ultrasound has become a proven tool, especially in the gastrointestinal tract, because it provides extremely low-risk accurate image material from this region. The procedure is very similar to gastroscopy and colonoscopy, respectively – the only difference being the ultrasound images captured by the small probe. This special instrument is only slightly thicker than the endoscopes used for ordinary endoscopy. It is excellent for checking the condition of walls of the esophagus and stomach, duodenum and rectum. Even changes that are only a few millimeters in size can be detected with endosonography. Thanks to the often early detection, any tumors can be treated particularly well. Flexible endoscopes ensure that the physician can also gain insight into rather inaccessible areas of the body. Particularly fine probes that can be inserted into the ductal systems of the digestive system are suitable for detecting diseases in the gallbladder and pancreas. With the help of endoscopes equipped with special devices, tissue samples can be taken or cysts emptied during the examination. In the case of conspicuous findings, initial statements can be made about the benign or malignant nature of a polyp or the depth to which a tumor is located in the tissue. Endosonography also already plays an important role in the field of rectal diseases. By inserting the relatively thin endoscope with transducer into the rectum, it is possible to check for hemorrhoid operations, clarify defecation disorders and search for benign or malignant tumors. In addition, this allows for low-stress aftercare following cancer therapies. In the gynecological field, for example when a woman complains of pain or persistent bleeding or is in early pregnancy, vaginal ultrasound is also used to perform sonography inside the body. With the help of a rod-shaped device that has a transducer, a meaningful overview of the small pelvis is possible. Tumors, inflammations and various sources of bleeding can be detected. In pregnant women – without any dangerous radiation – the correct position of the pregnancy and the timely development of the embryo can be checked. In the case of symptoms in the respiratory tract or the chest, endosonography can also be used as part of a bronchoscopy. Here, the bronchial tubes can be extensively assessed from the inside and tissue samples can also be taken for further clarification in the same diagnostic step.
Risks, side effects and dangers
As far as diagnostics with ultrasound waves are concerned, endosonography is an absolutely risk-free examination method. It does not pose any danger even for pregnant women and infants. In contrast to computer tomography (CT), magnetic resonance imaging (MRI) and scintigraphy, which belongs to the field of nuclear medicine, endosonography, like classical ultrasound, does not require the use of contrast media or radioactive substances. The examination procedure is therefore completely safe, even for allergy sufferers, and can be repeated as often as seems necessary. Risks – although usually very small – arise only from the insertion of the endoscope into the various body cavities. As with classical endoscopies, there is also a (very small) risk of injuring tissue and causing bleeding during endosonography. The various forms of anesthesia or sedation are associated with varying degrees of risk to the patient. The range of choices from light sleep injection to general anesthesia is related to the region being examined and the patient’s physical as well as psychological condition. The preparation for endosonography also varies – depending on the region of the body to be examined. For examinations under anesthesia, the patient must always be fasting. This also applies to diagnostics of the gastrointestinal tract, since sonography – like gastroscopy and colonoscopy – is made difficult or impossible by food residues. For rectoscopy, there is no need for food abstinence, as the examination area can be prepared without complications with an enema. Vaginal ultrasound should take place outside of menstruation if possible, but is possible at any time in urgent cases.
Typical and common diseases of the digestive tract
- Gastric ulcer
- Inflammation of the gastric mucosa (gastritis)
- Stomach flu
- Irritable stomach
- Stomach cancer
- Crohn’s disease (chronic inflammation of the intestine)
- Appendicitis
