Endoscopic Ultrasound

Endoscopic UltraSound (EUS)

What is EUS?

EUS combines the technology of the endoscope with that of modern ultrasonography to allow placement of ultrasound probes very close to an abnormality in the gastro-intestinal tract to get high resolution detail of the anatomy.

This allows accurate diagnosis, staging and direct sampling of pathology.

EUS allows accurate diagnostic and therapeutic intervention of pathology in and adjacent to the GI tract. Indications include:

  • Assessment of sub-mucosal lesions found at endoscopy
  • Staging of gastro-oesophageal malignancies
  • Staging and sampling of pancreatic masses
  • Assessment and sampling of pancreatic cysts
  • Assessment of the biliary tract (e.g. stones vs. malignancy)
  • Staging of ampullary masses
  • Core sampling of mediastinal and upper abdominal lymph nodes (including aorto-caval) for lymphoma
  • Staging of lung cancers (left adrenal, position 2,4,7,8 and 10 lymph nodes can be accessed)
  • Celiac plexus neurolysis for malignancy related pain

The following EUS procedures are offered at Waitemata Endoscopy;

  1. Radial and Linear EUS imaging.
  2. EUS-Fine Needle Aspiration (FNA) or Biopsy
  3. EUS-Guided Celiac Plexus Block/Neurolysis


Radial EUS

Fine high frequency EUS probes can be passed down conventional endoscopes and with the aid of instilled water used to interrogate in detail the size, ultrasonographic anatomy and layer of origin of small, submucosal lesions.

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Linear EUS

EUS also allows the positioning of needles under direct ultrasound guidance into organs or lymph nodes adjacent to the gastro intestinal tract to gain tissue samples.
This is called EUS-Fine Needle Aspiration-Biopsy (EUS-FNA/B)

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The same ability to pass a needle in to tissues to sample them also allows the possibility of administering drugs.

When patients have intractable pain in the back or abdomen from serious conditions like chronic pancreatitis or cancer it is possible to anaesthetise the nerves involved with an EUS-guided Celiac Plexus Block/Neurolysis.

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Dr. Walmsley introduced this procedure to New Zealand in 2003, and is the most experienced Endoscopic Ultrasound practitioner in the country.  His overseas training included time at the Chinese University of Hong Kong and St Thomas’ Hospital in London.

For further information, Dr Walmsley can be contacted at his rooms at gastro@wsurg.co.nz, or to arrange an EUS, referrals can be forwarded directly to Waitemata Endoscopy at admin@waitemataendoscopy.co.nz.