Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Jan 25, 2016; 8(2): 104-112
Published online Jan 25, 2016. doi: 10.4253/wjge.v8.i2.104
Endoscopic ultrasound-guided interventions in special situations
Varayu Prachayakul, Pitulak Aswakul
Varayu Prachayakul, Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok 10700, Thailand
Pitulak Aswakul, Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok 10120, Thailand
Author contributions: Prachayakul V conceived of and designed the article; Prachayakul V and Aswakul P reviewed the literature and drafted, revised, and approved the final version of the article to be published.
Conflict-of-interest statement: Both authors declare no conflict of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See:
Correspondence to: Varayu Prachayakul, MD, Associate Professor, Siriraj Gastrointestinal Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, 2 Prannok Road, Bangkok 10700, Thailand.
Telephone: +66-81-8654646 Fax: +66-2-4115013
Received: May 24, 2015
Peer-review started: May 25, 2015
First decision: August 16, 2015
Revised: September 7, 2015
Accepted: December 1, 2015
Article in press: December 2, 2015
Published online: January 25, 2016

Endoscopic ultrasound (EUS) was introduced in 1982 and has since become a popular advanced procedure for diagnosis and therapeutic intervention. Initially, EUS was most commonly used for the diagnosis of pancreatobiliary diseases and tissue acquisition. EUS was first used for guided cholangiography in 1996, followed by EUS-guided biliary drainage in 2001. Advancements in equipment and endoscopic accessories have led to an expansion of EUS-guided procedures, which now include EUS-guided drainage of intra-abdominal abscesses or collections, intra-vascular treatment of refractory variceal and nonvariceal bleeding, transmural pancreatic drainage, common bile duct stone clearance, enteral feeding tube placement and entero-enteric anastomosis. Patients with surgically altered upper gastrointestinal anatomies have greatly benefited from EUS also. This systematic review describes and discusses EUS procedures performed in uncommon diseases and conditions, as well as applications on more vulnerable patients such as young children and pregnant women. In these cases, routine approaches do not always apply, and thus may require the use of innovative and unconventional techniques. Increased knowledge of such special applications will help increase the success rates of these procedures and provide a foundation for additional advances and utilizations of the technique.

Keywords: Children, Endoscopic ultrasonography, Intra-abdominal abscesses, Pregnancy, Special situation, Surgically altered anatomy, Therapeutic, Uncommon

Core tip: This article reviews the clinical applications of endoscopic ultrasound-guided interventions reported to date, including drainage of intra-abdominal collections, gallbladder and pancreas. Procedures used in pregnant women and children are also described. The aim of this review was to promote knowledge of special clinical applications in which endoscopic ultrasound is applicable.