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Internal Medicine / Gastroenterology: Interventional Endoscopy

Interventional endoscopy is a division of Gastroenterology that performs pancreatic and biliary endoscopy, advanced staging of digestive tumors and pancreatic tumors. Two of their main procedures are Endoscopic Retrograde Cholangiopancreatography (ERCP) and endoscopic ultrasonography (EUS). The specialists in the Interventional Endoscopy division have gained exceptional expertise from their high volume of these tests: about 1000 ERCPs and 900 EUS each year.  For more information about interventional endoscopy, you can visit their site:

Patients must be referred by their primary physician or another specialist.


Patients are seen for consultation on:

Center for Advanced Medicine
GI Center
4921 Parkview Place, Suite C, Floor 8
St. Louis, MO 63110

Endoscopic procedures are performed in the Endoscopy Suite on the 10th floor.

Our specialists include:

Steven Alphonse Edmundowicz, M.D., Director

Riad Raymond Azar, M.D.

Dayna S. Early, M.D.

Daniel K. Mullady, M.D.

Faris M. Murad, MD

Endoscopic Retrograde Cholangiopancreatography (ERCP)

ERCP is a specialized technique used to study the drainage ducts of the gallbladder, pancreas and liver. The procedure is used primarily to diagnose and treat conditions of the bile ducts, including gallstones, inflammatory blockages from scarring, leaks (from trauma and surgery), and cancer. ERCP combines the use of x rays and an endoscope, which is a long, flexible, lighted tube, inserted through the mouth, down the esophagus, through the stomach and into the duodenum, the first part of the small intestine, where the bile ducts can be entered.

Through the endoscope, the physician can see the inside of the stomach and duodenum, and inject dyes into the bile ducts and pancreas so they can be seen on X-rays. If the exam shows a gallstone or narrowing of the ducts, the physician can insert instruments into the scope to remove or relieve the obstruction. Also, tissue samples (biopsy) can be taken for further testing.

ERCP is a valuable tool for diagnosis many diseases of the pancreas, bile ducts, liver, and gallbladder. It can help determine whether a symptom is due to a medical cause, or a blockage that can be corrected. For more information on this procedure go to the American Society of Gastrointestinal Endoscopy website.

Endoscopic Ultrasonography (EUS)

EUS allows the doctor to examine the stomach lining, and the walls of the upper and lower gastrointestinal tract, as well as study internal organs that are close to the GI tract, like the gall bladder and pancreas. The endoscopic specialist passes a thin flexible tube to the area to be examined. For the upper GI tract (esophagus, stomach, and duodenum), it goes through the mouth. For the lower GI tract (colon and rectum), it would be passed through the anus.

EUS can be used to diagnose the cause of conditions such as abdominal pain or abnormal weight loss. It can also be used to evaluate an abnormality, such as a lump, or diseases of the pancreas, bile duct, or gallbladder. For cancer patients, it can help determine the extent of certain cancers, to accurately assess its depth and whether it has spread to adjacent lymph nodes. In some cases, it can be used to obtain biopsy samples. For more complete information on this procedure, visit the ASGE website.

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Copyright 2015 Washington University School of Medicine
Copyright 2015 Washington University School of Medicine