Endoscopy 2024; 56(06): 462
DOI: 10.1055/a-2266-2935
E-Videos

Commentary

Tomas Hucl
1   Department of Gastroenterology and Hepatology, Institute for Clinical and Experimental Medicine, Prague, Czech Republic
› Author Affiliations

EUS-guided gastroenterostomy (EUS-GE) is becoming widely used to treat gastric outlet obstruction as an alternative to luminal stenting or laparoscopic surgery [11]. However, the procedure requires high technical skills and experience in order to prevent, recognize, and manage procedure-related adverse events.

In this video, Shah et al. report a case of interposed colon between the stomach and the jejunal loop. The presence of the interfering colon with all its typical EUS features was obvious only when the tip of the scope was released, demonstrating the importance of this maneuver during EUS-GE.

Inadvertent gastrocolostomy is a rare complication of EUS-GE, reported in 0.4%–2.4% of patients [22] [33]. This case further demonstrates not only that procedure cessation may prevent a severe adverse event possibly requiring surgery, but also that a repeated procedure a couple of days later may be successful in this setting.



Publication History

Article published online:
29 May 2024

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  • References

  • 1 Van der Merwe SW, van Wanrooij RLJ, Bronswijk M. et al. Therapeutic endoscopic ultrasound: European Society of Gastrointestinal Endoscopy (ESGE) Guideline. Endoscopy 2022; 54: 185-205 DOI: 10.1055/a-1717-1391. (PMID: 34937098)
  • 2 Ghandour B, Bejjani M, Irani SS. et al. Classification, outcomes, and management of misdeployed stents during EUS-guided gastroenterostomy. Gastrointest Endosc 2022; 95: 80-89
  • 3 Park KH, Rosas US, Liu QY. et al. Safety of teaching endoscopic ultrasound-guided gastroenterostomy (EUS-GE) can be improved with standardization of the technique. Endosc Int Open 2022; 10: 1088-1094