Review
Copyright ©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Endosc. Aug 10, 2015; 7(10): 960-968
Published online Aug 10, 2015. doi: 10.4253/wjge.v7.i10.960
Uncommon complications of therapeutic endoscopic ultrasonography: What, why, and how to prevent
Tanyaporn Chantarojanasiri, Pitulak Aswakul, Varayu Prachayakul
Tanyaporn Chantarojanasiri, Division of Gastroenterology, Department of Internal Medicine, Police General Hospital, Bangkok 10330, Thailand
Pitulak Aswakul, Liver and Digestive Institute, Samitivej Sukhumvit Hospital, Bangkok 10120, Thailand
Varayu Prachayakul, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok 10700, Thailand
Author contributions: Prachayakul V conceived of and designed the article; Chantarojanasiri T reviewed the literature and drafted the article; all the authors revised and approved the final version to be published.
Conflict-of-interest statement: All authors declare that they have no conflicts 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: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Varayu Prachayakul, Associate Professor, Siriraj GI Endoscopy Center, Division of Gastroenterology, Department of Internal Medicine, Siriraj Hospital, Faculty of Medicine, Mahidol University, Bangkok 10700, Thailand. kaiyjr@gmail.com
Telephone: +66-841-8654646 Fax: +66-2-4115013
Received: March 26, 2015
Peer-review started: March 28, 2015
First decision: April 17, 2015
Revised: May 4, 2015
Accepted: July 7, 2015
Article in press: July 8, 2015
Published online: August 10, 2015
Abstract

There is an increasing role for endoscopic ultrasound (EUS)-guided interventions in the treatment of many conditions. Although it has been shown that these types of interventions are effective and safe, they continue to be considered only as alternative treatments in some situations. This is in part due to the occurrence of complications with these techniques, which can occur even when performed by experienced endosonographers. Although common complications have been described for many procedures, it is also crucial to be aware of uncommon complications. This review describes rare complications that have been reported with several EUS-guided interventions. EUS-guided biliary drainage is accepted as an alternative treatment for malignant biliary obstruction. Most of the uncommon complications related to this procedure involve stent malfunction, such as the migration or malposition of stents. Rare complications of EUS-guided pancreatic pseudocyst drainage can result from air embolism and infection. Finally, a range of uncommon complications has been reported for EUS-guided celiac plexus neurolysis, involving neural and vascular injuries that can be fatal. The goal of this review is to identify possible complications and promote an understanding of how they occur in order to increase general awareness of these adverse events with the hope that they can be avoided in the future.

Keywords: Complications, Endoscopic ultrasonography, Rare, Therapeutic, Uncommon

Core tip: This article reviews the rare complications that occur with endoscopic ultrasound-guided interventions, including those for biliary and pancreatic pseudocyst drainage and celiac plexus neurolysis. Knowledge of the types of rare complications will promote an understanding of their causes, and help to reduce their occurrence.