WHAT IS EUS?

Endoscopic ultrasound (EUS) is an advance in gastrointestinal endoscopy. First developed in the 1980s to overcome the limitations of transabdominal ultrasound for imaging of the pancreas, it is now an established tool in the management of pancreaticobiliary disease and the examination of subepithelial lesions in the upper and lower GI tract. It is also a sensitive tool for staging of esophageal and rectal cancers.

When combined with a procedure called fine-needle aspiration (FNA), EUS allows for sampling of fluid and tissue from the abdomen. EUS with FNA can be a minimally-invasive alternative to exploratory surgery. Despite its superiority, EUS is underutilized when compared to other endoscopic procedures. EUS is provided by a very limited number of gastroenterologists, mainly in academic and tertiary centers.

A retrospective study done by Dr. Purohit-Goyal and endosonographers at Allegheny General Hospital in Pittsburgh was published in Digestive Diseases and Sciences in 2014. The study proved that EUS is a low-risk, high-yield technique that should be made more widely available so that patients do not have to wait for months to undergo a diagnostic work up.

The study also showed that there is no difference between the cytological yield of EUS-FNA for solid lesions, cysts, or lymph nodes. At the community hospital where the study was performed there were no major acute complications, suggesting that with adequately trained endosonographers and cytologists and rapid onsite evaluation, community hospitals can achieve outcomes similar to well-established academic centers and can meet tertiary care standards for EUS. https://www.ncbi.nlm.nih.gov/pubmed/24573718

PHYSICIAN SPOTLIGHT: DR. TRETA PUROHIT-GOYAL

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Introducing the author of the EUS study and one of SJGI’s treasures—Dr. Treta Purohit-Goyal!

She is a well-rounded general gastroenterologist with special interests in colorectal cancer screening, GERD, inflammatory bowel disease, and pancreaticobiliary disease. Furthermore, she is trained in Endoscopic Ultrasound (EUS) and Endoscopic Retrograde Cholangiopancreatography (ERCP).

Dr. Purohit-Goyal completed her medical training from T.N. Medical College in Mumbai. She followed this with a Master’s in Public Health focused on Epidemiology and Infectious Diseases from Johns Hopkins University. She completed her Internal Medicine residency at the Westchester Medical Center, New York Medical College, in Valhalla, New York.

She received numerous teaching awards during residency and was awarded Outstanding Resident of the Year in her final year. She then trained in Gastroenterology and Hepatology at the William Beaumont Hospital System in Royal Oak, Michigan.

In her free time, Dr. Purohit-Goyal enjoys yoga, traveling, and going on nature hikes with her husband.

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