title: Endoscopic ultrasound-assisted gastrointestinal hemostasis: an evolving technique.
abstract: Gastrointestinal bleeding can range from grossly visible blood in stool or vomitus to microscopic bleed. However, any kind of bleeding can lead to potential life-threatening consequences. A small proportion of patients with gastrointestinal bleeding remain refractory to initial endoscopic hemostasis. While some are successfully managed by repeat endoscopic intervention, a few fail to respond or are not amenable to endoscopic hemostasis. As of now, the next level of intervention is passed on to either surgeons or interventional radiologists. There is new evidence suggesting the increased utility of endoscopic ultrasound (EUS) in diagnosis and treatment of culprit vascular lesions across the gut. In addition, EUS-assisted technique has also been used in the primary prevention of bleeding from gastroesophageal varices. In this review article, we have summarized case series and reports describing the use of EUS-assisted hemostasis. Indications, techniques, complications and success rates reported are discussed. While most of the authors describe their experience with primary and secondary treatment of gastric varices, treatment of other gastrointestinal lesions with EUS assisted hemostatic techniques is also discussed.
authors.affiliation: Department of Internal Medicine, Albert Einstein medical center, Philadelphia, PA, USA.
authors.forename: Deepanshu
authors.initials: D
authors.lastname: Jain
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Texas Health Science Center at Houston, Houston, TX, USA.
authors.forename: Nirav
authors.initials: N
authors.lastname: Thosani
authors.affiliation: Division of Gastroenterology, Hepatology and Nutrition, University of Texas Health Science Center at Houston, 6431 Fannin, MSB 4.234, Houston, TX 77030, USA.
authors.forename: Shashideep
authors.initials: S
authors.lastname: Singhal
keywords: coil; endoscopic ultrasound; gastrointestinal bleeding; glue; hemostasis; injection; technique