What is rectal endoscopic ultrasound?
Rectal endoscopic ultrasound (EUS) is a way to determine the local extent of a cancer or polyp of the rectum. Your doctor uses a narrow, flexible tube with an ultrasound tip to see if cancer has grown through the outer lining of the rectum. Additionally, your doctor can look for lymph glands and take a biopsy with a fine needle to determine if cancer has spread.

When is it used?
The doctor may suggest this procedure if:

• You have cancer of the rectum
• You have a large polyp of the rectum and there is concern for cancer
• You have had a cancerous polyp removed and your doctor wants to look for lymph glands

How do I prepare for a rectal EUS?
You will be given two enemas to take the morning of your test to cleanse the end of your colon. You do not have to fast for this test.

What happens during the procedure?
The doctor will insert a tube with an ultrasound tip into your rectum. The doctor will then use ultrasound to view the cancer or polyp and determine the local spread or extent.

You may experience some minimal discomfort, but this test is generally not painful. No sedatives or pain medications are usually required to perform this test. However, if you are experiencing pain in your rectum, you can request a sedative.

Should your doctor need to take a needle sample of a lymph gland, you would be given a sedative as this can have some discomfort associated with it. You would also be given antibiotics to prevent infection.

What happens after the procedure?
If you were not given a sedative, you can go home immediately following the procedure and resume your normal activity.

If you did receive a sedative, you will be observed for about 30 minutes and then would go home. Because you should not drive or do anything that requires coordination or quick response, you should have someone pick you up from the hospital.

What are the benefits of the procedure?
Your doctor will hopefully be able to determine the local extent of your cancer or polyp. This information will help guide your further care.

What are the risks associated with this procedure?

• Your rectum or colon may be hurt or punctured.
• There is a risk of infection and bleeding

You should ask your doctor how these risks apply to you.

When should I call the doctor?
Call the doctor immediately if:

• You develop severe abdominal pain
• You feel nauseated
• You vomit
• You develop a fever

Call the doctor during office hours if:

• You have questions about the procedure or its results
• You want to make another appointment

This article is intended as a resource for patients receiving their cancer care at Duke University Hospital or Duke Clinic. It is not intended to substitute for medical advice from your health care team. If your doctor’s instructions differ from the information in this article, please talk with your doctor before making any changes.

Source: Duke Cancer Patient Education Program / Patient & Family Education Committee 8/00