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Rectal Endoscopic Ultrasound in Clinical Practice

  • Large Intestine (B Cash and R Chokshi, Section Editors)
  • Published:
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Abstract

Purpose of Review

Endoscopic ultrasound (EUS) is routinely utilized for evaluation of disorders of the lower gastrointestinal tract. In this review, we summarize the current status of rectal EUS in clinical practice and describe recent developments in diagnostic and therapeutic rectal EUS.

Recent Findings

Recent guidelines recommend rectal EUS for rectal cancer staging as a second line modality in cases where MRI is contraindicated. Forward-viewing echoendoscopes and through the scope EUS miniprobes allow for EUS imaging of lesions through the entire colon and for evaluation beyond stenoses or luminal narrowings. EUS can be used to assess perianal disease and drain pelvic abscess associated with IBD, along with newer applications currently under investigation. For rectal varices, EUS can confirm the diagnosis, assess the optimal site for banding, guide therapy placement with sclerotherapy and/or coils, and assess response to treatment by confirming absence of flow. Therapeutic rectal EUS is emerging as a promising modality for drainage of pelvic fluid collection drainage and fiducial placement for rectal or prostatic cancer. Drug delivery mechanisms and substances that may increase the scope of therapy with rectal EUS are in varying stages of development.

Summary

Rectal EUS continues to be an important modality for evaluation of benign and malignant disorders of the lower gastrointestinal tract, although its use as a cancer staging modality has declined due to improvements in MRI technology. Various technologies to enhance ultrasound imaging and for therapeutics have been developed that have or may contribute to expanded indications for rectal EUS.

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References

Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

  1. Committee ASoP, Early DS, Acosta RD, Chandrasekhara V, Chathadi KV, Decker GA, et al. Adverse events associated with EUS and EUS with FNA. Gastrointest Endosc. 2013;77(6):839–43. https://doi.org/10.1016/j.gie.2013.02.018.

    Article  Google Scholar 

  2. Cartana ET, Gheonea DI, Saftoiu A. Advances in endoscopic ultrasound imaging of colorectal diseases. World J Gastroenterol. 2016;22(5):1756–66. https://doi.org/10.3748/wjg.v22.i5.1756.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. •• Benson AB 3rd, Venook AP, Al-Hawary MM, Cederquist L, Chen YJ, Ciombor KK, et al. Rectal Cancer, version 2.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2018;16(7):874–901. https://doi.org/10.6004/jnccn.2018.0061 Up to date guidelines for rectal cancer staging.

    Article  Google Scholar 

  4. Balyasnikova S, Brown G. Optimal imaging strategies for rectal cancer staging and ongoing management. Curr Treat Options in Oncol. 2016;17(6):32. https://doi.org/10.1007/s11864-016-0403-7.

    Article  Google Scholar 

  5. • Waage JE, Leh S, Rosler C, Pfeffer F, Bach SP, Havre RF, et al. Endorectal ultrasonography, strain elastography and MRI differentiation of rectal adenomas and adenocarcinomas. Color Dis. 2015;17(2):124–31. https://doi.org/10.1111/codi.12845 Strain ratio on EUS elastography was 94% accurate in differentiating adenomas from adenocarcinomas.

    Article  CAS  Google Scholar 

  6. Mondal D, Betts M, Cunningham C, Mortensen NJ, Lindsey I, Slater A. How useful is endorectal ultrasound in the management of early rectal carcinoma? Int J Color Dis. 2014;29(9):1101–4. https://doi.org/10.1007/s00384-014-1920-0.

    Article  CAS  Google Scholar 

  7. Samee A, Selvasekar CR. Current trends in staging rectal cancer. World J Gastroenterol. 2011;17(7):828–34. https://doi.org/10.3748/wjg.v17.i7.828.

    Article  PubMed  PubMed Central  Google Scholar 

  8. Marone P, de Bellis M, D'Angelo V, Delrio P, Passananti V, Di Girolamo E, et al. Role of endoscopic ultrasonography in the loco-regional staging of patients with rectal cancer. World J Gastrointest Endosc. 2015;7(7):688–701. https://doi.org/10.4253/wjge.v7.i7.688.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Group MS. Extramural depth of tumor invasion at thin-section MR in patients with rectal cancer: results of the MERCURY study. Radiology. 2007;243(1):132–9. https://doi.org/10.1148/radiol.2431051825.

    Article  Google Scholar 

  10. Kim MJ. Transrectal ultrasonography of anorectal diseases: advantages and disadvantages. Ultrasonography. 2015;34(1):19–31. https://doi.org/10.14366/usg.14051.

    Article  CAS  PubMed  Google Scholar 

  11. Group MS. Diagnostic accuracy of preoperative magnetic resonance imaging in predicting curative resection of rectal cancer: prospective observational study. BMJ. 2006;333(7572):779. https://doi.org/10.1136/bmj.38937.646400.55.

    Article  Google Scholar 

  12. Vanagunas A, Lin DE, Stryker SJ. Accuracy of endoscopic ultrasound for restaging rectal cancer following neoadjuvant chemoradiation therapy. Am J Gastroenterol. 2004;99(1):109–12.

    Article  Google Scholar 

  13. Patel UB, Taylor F, Blomqvist L, George C, Evans H, Tekkis P, et al. Magnetic resonance imaging-detected tumor response for locally advanced rectal cancer predicts survival outcomes: MERCURY experience. J Clin Oncol. 2011;29(28):3753–60. https://doi.org/10.1200/JCO.2011.34.9068.

    Article  PubMed  Google Scholar 

  14. Smith JJ, Chow OS, Gollub MJ, Nash GM, Temple LK, Weiser MR, et al. Organ preservation in rectal adenocarcinoma: a phase II randomized controlled trial evaluating 3-year disease-free survival in patients with locally advanced rectal cancer treated with chemoradiation plus induction or consolidation chemotherapy, and total mesorectal excision or nonoperative management. BMC Cancer. 2015;15:767. https://doi.org/10.1186/s12885-015-1632-z.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  15. Yahya JB, Farrell MJ, Herzig DO, Degnin CR, Chen Y, Holland J, et al. Preferential use of imaging modalities in staging newly diagnosed rectal cancer: a survey of US radiation oncologists. J Gastrointest Oncol. 2018;9(3):435–40. https://doi.org/10.21037/jgo.2018.01.19.

    Article  PubMed  PubMed Central  Google Scholar 

  16. Bipat S, Glas AS, Slors FJ, Zwinderman AH, Bossuyt PM, Stoker J. Rectal cancer: local staging and assessment of lymph node involvement with endoluminal US, CT, and MR imaging--a meta-analysis. Radiology. 2004;232(3):773–83. https://doi.org/10.1148/radiol.2323031368.

    Article  PubMed  Google Scholar 

  17. Ashraf S, Hompes R, Slater A, Lindsey I, Bach S, Mortensen NJ, et al. A critical appraisal of endorectal ultrasound and transanal endoscopic microsurgery and decision-making in early rectal cancer. Color Dis. 2012;14(7):821–6. https://doi.org/10.1111/j.1463-1318.2011.02830.x.

    Article  CAS  Google Scholar 

  18. Okafor PN, Swanson K, Shah N, Talwalkar JA. Endoscopic ultrasound for rectal cancer staging: a population-based study of utilization, impact on treatment patterns, and survival. J Gastroenterol Hepatol. 2018;33(8):1469–76. https://doi.org/10.1111/jgh.14098.

    Article  PubMed  Google Scholar 

  19. • El H II, DeWitt J, Sherman S, Imperiale TF, LeBlanc JK, McHenry L, et al. Prospective evaluation of the performance and interobserver variation in endoscopic ultrasound staging of rectal cancer. Eur J Gastroenterol Hepatol. 2018;30(9):1013–8. https://doi.org/10.1097/MEG.0000000000001176 This study evaluated EUS for rectal staging prospectively with tandem exam and showed good accuracy good interobserver agreement for early T stage, but poor interobsrver agreement for N stages.

    Article  Google Scholar 

  20. Eisen GM, Dominitz JA, Faigel DO, Goldstein JA, Petersen BT, Raddawi HM, et al. Guidelines for credentialing and granting privileges for endoscopic ultrasound. Gastrointest Endosc. 2001;54(6):811–4.

    Article  CAS  Google Scholar 

  21. • Arya N, Sahai AV, Paquin SC. Credentialing for endoscopic ultrasound: a proposal for Canadian guidelines. Endosc Ultrasound. 2016;5(1):4–7. https://doi.org/10.4103/2303-9027.175875 Canadian guidelines recommending 25 rectal EUS prior to receiving privileges for independent practice.

    Article  PubMed  PubMed Central  Google Scholar 

  22. •• Wani S, Wallace MB, Cohen J, Pike IM, Adler DG, Kochman ML, et al. Quality indicators for EUS. Gastrointest Endosc. 2015;81(1):67–80. https://doi.org/10.1016/j.gie.2014.07.054 ASGE guidelines for quality indicators for EUS.

    Article  PubMed  Google Scholar 

  23. Maleki Z, Erozan Y, Geddes S, Li QK. Endorectal ultrasound-guided fine-needle aspiration: a useful diagnostic tool for perirectal and intraluminal lesions. Acta Cytol. 2013;57(1):9–18. https://doi.org/10.1159/000342919.

    Article  PubMed  Google Scholar 

  24. Liu S, Zhong GX, Zhou WX, Xue HD, Pan WD, Xu L, et al. Can endorectal ultrasound, MRI, and mucosa integrity accurately predict the complete response for mid-low rectal cancer after preoperative chemoradiation? A prospective observational study from a single medical center. Dis Colon Rectum. 2018;61(8):903–10. https://doi.org/10.1097/DCR.0000000000001135.

    Article  PubMed  Google Scholar 

  25. Kongkam P, Linlawan S, Aniwan S, Lakananurak N, Khemnark S, Sahakitrungruang C, et al. Forward-viewing radial-array echoendoscope for staging of colon cancer beyond the rectum. World J Gastroenterol. 2014;20(10):2681–7. https://doi.org/10.3748/wjg.v20.i10.2681.

    Article  PubMed  PubMed Central  Google Scholar 

  26. Castro-Pocas FM, Dinis-Ribeiro M, Rocha A, Santos M, Araujo T, Pedroto I. Colon carcinoma staging by endoscopic ultrasonography miniprobes. Endosc Ultrasound. 2017;6(4):245–51. https://doi.org/10.4103/2303-9027.190921.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Benson AB 3rd, Venook AP, Al-Hawary MM, Cederquist L, Chen YJ, Ciombor KK, et al. Anal carcinoma, version 2.2018, NCCN clinical practice guidelines in oncology. J Natl Compr Cancer Netw. 2018;16(7):852–71. https://doi.org/10.6004/jnccn.2018.0060.

    Article  Google Scholar 

  28. Kochhar R, Plumb AA, Carrington BM, Saunders M. Imaging of anal carcinoma. AJR Am J Roentgenol. 2012;199(3):W335–44. https://doi.org/10.2214/AJR.11.8027.

    Article  PubMed  Google Scholar 

  29. Stewart DB, Gaertner WB, Glasgow SC, Herzig DO, Feingold D, Steele SR, et al. The American Society of Colon and Rectal Surgeons clinical practice guidelines for anal squamous cell cancers (revised 2018). Dis Colon Rectum. 2018;61(7):755–74. https://doi.org/10.1097/DCR.0000000000001114.

    Article  PubMed  Google Scholar 

  30. Otto SD, Lee L, Buhr HJ, Frericks B, Hocht S, Kroesen AJ. Staging anal cancer: prospective comparison of transanal endoscopic ultrasound and magnetic resonance imaging. J Gastrointest Surg. 2009;13(7):1292–8. https://doi.org/10.1007/s11605-009-0870-2.

    Article  CAS  PubMed  Google Scholar 

  31. Leblanc J, Kongkam P. Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) diagnosis of recurrent anal cancer after chemoradiation and negative forceps biopsies: a case report. Clin Med Oncol. 2009;3:59–62.

    PubMed  PubMed Central  Google Scholar 

  32. Katsinelos P, Papaziogas B, Chatzimavroudis G, Katsinelos T, Dimou E, Atmatzidis S, et al. Secondary rectal linitis plastica as first manifestation of urinary bladder carcinoma. Ann Gastroenterol. 2012;25(2):173–5.

    PubMed  PubMed Central  Google Scholar 

  33. Schwartz DA, Harewood GC, Wiersema MJ. EUS for rectal disease. Gastrointest Endosc. 2002;56(1):100–9.

    Article  Google Scholar 

  34. Wang S, Sun S, Liu X, Ge N, Wang G, Guo J, et al. Endoscopic diagnosis of primary anorectal melanoma. Oncotarget. 2017;8(30):50133–40. https://doi.org/10.18632/oncotarget.15495.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Kikuchi Y, Matsui T, Hisabe T, Wada Y, Hoashi T, Tsuda S, et al. Deep infiltrative low-grade MALT (mucosal-associated lymphoid tissue) colonic lymphomas that regressed as a result of antibiotic administration: endoscopic ultrasound evaluation. J Gastroenterol. 2005;40(8):843–7. https://doi.org/10.1007/s00535-005-1639-3.

    Article  PubMed  Google Scholar 

  36. Takao Y, Shimamoto C, Hazama K, Itakura H, Sasaki S, Umegaki E, et al. Primary rectal teratoma: EUS features and review of the literature. Gastrointest Endosc. 2000;51(3):353–5.

    Article  CAS  Google Scholar 

  37. Artifon EL, Sakai P, Ishioka S, Silva AF, Maluf F, Chaves D, et al. EUS for locoregional staging of prostate cancer--a pilot study. Gastrointest Endosc. 2007;65(3):440–7. https://doi.org/10.1016/j.gie.2006.10.050.

    Article  PubMed  Google Scholar 

  38. Sharma M, Somani P, Patil A, Kumar A, Shastri C. EUS of solitary rectal ulcer syndrome. Gastrointest Endosc. 2017;85(4):858–9. https://doi.org/10.1016/j.gie.2016.05.040.

    Article  PubMed  Google Scholar 

  39. Schizas AM, Williams AB, Meenan J. Endosonographic staging of lower intestinal malignancy. Best Pract Res Clin Gastroenterol. 2009;23(5):663–70. https://doi.org/10.1016/j.bpg.2009.06.006.

    Article  PubMed  Google Scholar 

  40. Worrell S, Horvath K, Blakemore T, Flum D. Endorectal ultrasound detection of focal carcinoma within rectal adenomas. Am J Surg. 2004;187(5):625–9; discussion 9. https://doi.org/10.1016/j.amjsurg.2004.01.005.

    Article  PubMed  Google Scholar 

  41. Doornebosch PG, Bronkhorst PJ, Hop WC, Bode WA, Sing AK, de Graaf EJ. The role of endorectal ultrasound in therapeutic decision-making for local vs. transabdominal resection of rectal tumors. Dis Colon Rectum. 2008;51(1):38–42. https://doi.org/10.1007/s10350-007-9104-4.

    Article  CAS  PubMed  Google Scholar 

  42. Luz LP, Cote GA, Al-Haddad MA, McHenry L, LeBlanc JK, Sherman S, et al. Utility of EUS following endoscopic polypectomy of high-risk rectosigmoid lesions. Endosc Ultrasound. 2015;4(2):137–44. https://doi.org/10.4103/2303-9027.156744.

    Article  PubMed  PubMed Central  Google Scholar 

  43. Havre R, Gilja OH. Elastography and strain rate imaging of the gastrointestinal tract. Eur J Radiol. 2014;83(3):438–41. https://doi.org/10.1016/j.ejrad.2013.05.018.

    Article  CAS  PubMed  Google Scholar 

  44. Chen TH, Lin CJ, Wu RC, Ho YP, Hsu CM, Lin WP, et al. The application of miniprobe ultrasonography in the diagnosis of colorectal subepithelial lesions. Chang Gung Med J. 2010;33(4):380–8.

    PubMed  Google Scholar 

  45. Kida M, Kawaguchi Y, Miyata E, Hasegawa R, Kaneko T, Yamauchi H, et al. Endoscopic ultrasonography diagnosis of subepithelial lesions. Dig Endosc. 2017;29(4):431–43. https://doi.org/10.1111/den.12854.

    Article  PubMed  Google Scholar 

  46. Kim TO. Colorectal subepithelial lesions. Clin Endosc. 2015;48(4):302–7. https://doi.org/10.5946/ce.2015.48.4.302.

    Article  PubMed  PubMed Central  Google Scholar 

  47. Roseau G. Recto-sigmoid endoscopic-ultrasonography in the staging of deep infiltrating endometriosis. World J Gastrointest Endosc. 2014;6(11):525–33. https://doi.org/10.4253/wjge.v6.i11.525.

    Article  PubMed  PubMed Central  Google Scholar 

  48. Hwang JH, Saunders MD, Rulyak SJ, Shaw S, Nietsch H, Kimmey MB. A prospective study comparing endoscopy and EUS in the evaluation of GI subepithelial masses. Gastrointest Endosc. 2005;62(2):202–8.

    Article  Google Scholar 

  49. Chen HT, Xu GQ, Teng XD, Chen YP, Chen LH, Li YM. Diagnostic accuracy of endoscopic ultrasonography for rectal neuroendocrine neoplasms. World J Gastroenterol. 2014;20(30):10470–7. https://doi.org/10.3748/wjg.v20.i30.10470.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Alkhatib AA, Faigel DO. Endoscopic ultrasonography-guided diagnosis of subepithelial tumors. Gastrointest Endosc Clin N Am. 2012;22(2):187–205, vii. https://doi.org/10.1016/j.giec.2012.04.006.

    Article  PubMed  Google Scholar 

  51. Eckardt AJ, Jenssen C. Current endoscopic ultrasound-guided approach to incidental subepithelial lesions: optimal or optional? Ann Gastroenterol. 2015;28(2):160–72.

    PubMed  PubMed Central  Google Scholar 

  52. • El Chafic AH, Loren D, Siddiqui A, Mounzer R, Cosgrove N, Kowalski T. Comparison of FNA and fine-needle biopsy for EUS-guided sampling of suspected GI stromal tumors. Gastrointest Endosc. 2017;86(3):510–5. https://doi.org/10.1016/j.gie.2017.01.010 In a retrospecitve analysis of FNB vs FNA for subepithelial lesiosn throughout the GI tract, FNB was equally safe as FNA, with better tissue acquisition and improved diagnostic yield compared to FNA (86.7% vs 52.7%, p = 0.013.).

    Article  PubMed  Google Scholar 

  53. Abe T, Kakemura T, Fujinuma S, Maetani I. Successful outcomes of EMR-L with 3D-EUS for rectal carcinoids compared with historical controls. World J Gastroenterol. 2008;14(25):4054–8.

    Article  Google Scholar 

  54. Varas MJ, Gornals JB, Pons C, Espinos JC, Abad R, Lorente FJ, et al. Usefulness of endoscopic ultrasonography (EUS) for selecting carcinoid tumors as candidates to endoscopic resection. Rev Esp Enferm Dig. 2010;102(10):577–82.

    Article  CAS  Google Scholar 

  55. Siddiqui MR, Ashrafian H, Tozer P, Daulatzai N, Burling D, Hart A, et al. A diagnostic accuracy meta-analysis of endoanal ultrasound and MRI for perianal fistula assessment. Dis Colon Rectum. 2012;55(5):576–85. https://doi.org/10.1097/DCR.0b013e318249d26c.

    Article  PubMed  Google Scholar 

  56. Sloots CE, Felt-Bersma RJ, Poen AC, Cuesta MA, Meuwissen SG. Assessment and classification of fistula-in-ano in patients with Crohn's disease by hydrogen peroxide enhanced transanal ultrasound. Int J Color Dis. 2001;16(5):292–7.

    Article  CAS  Google Scholar 

  57. Felt-Bersma RJ. Endoanal ultrasound in benign anorectal disorders: clinical relevance and possibilities. Expert Rev Gastroenterol Hepatol. 2008;2(4):587–606. https://doi.org/10.1586/17474124.2.4.587.

    Article  PubMed  Google Scholar 

  58. Spradlin NM, Wise PE, Herline AJ, Muldoon RL, Rosen M, Schwartz DA. A randomized prospective trial of endoscopic ultrasound to guide combination medical and surgical treatment for Crohn's perianal fistulas. Am J Gastroenterol. 2008;103(10):2527–35. https://doi.org/10.1111/j.1572-0241.2008.02063.x.

    Article  PubMed  Google Scholar 

  59. Botti F, Losco A, Vigano C, Oreggia B, Prati M, Contessini Avesani E. Imaging techniques and combined medical and surgical treatment of perianal Crohn's disease. J Ultrasound. 2015;18(1):19–35. https://doi.org/10.1007/s40477-013-0042-9.

    Article  CAS  PubMed  Google Scholar 

  60. • Meylemans DVG, Oostenbrug LE, Bakker CM, Sosef MN, Stoot J, Belgers HJ. Endoscopic ultrasound guided versus surgical transrectal drainage of pelvic abscesses. Acta Chir Belg. 2018;118(3):181–7. https://doi.org/10.1080/00015458.2017.1411549 EUS guided drainage of pelvic abscess required onlt a single intervention for successful drianage in 83% vs 48% in the surgically drained group ( p = 0.016).

    Article  CAS  PubMed  Google Scholar 

  61. • Ellrichmann M, Wietzke-Braun P, Dhar S, Nikolaus S, Arlt A, Bethge J, et al. Endoscopic ultrasound of the colon for the differentiation of Crohn's disease and ulcerative colitis in comparison with healthy controls. Aliment Pharmacol Ther. 2014;39(8):823–33. https://doi.org/10.1111/apt.12671 EUS characteristics can differentiate UC from CD and quantify the degree of inflammation.

    Article  CAS  PubMed  Google Scholar 

  62. Ripolles T, Martinez-Perez MJ, Blanc E, Delgado F, Vizuete J, Paredes JM, et al. Contrast-enhanced ultrasound (CEUS) in Crohn's disease: technique, image interpretation and clinical applications. Insights Imaging. 2011;2(6):639–52. https://doi.org/10.1007/s13244-011-0124-1.

    Article  PubMed  PubMed Central  Google Scholar 

  63. Sidhu PS, Cantisani V, Dietrich CF, Gilja OH, Saftoiu A, Bartels E, et al. The EFSUMB guidelines and recommendations for the clinical practice of contrast-enhanced ultrasound (CEUS) in non-hepatic applications: update 2017 (short version). Ultraschall Med. 2018;39(2):154–80. https://doi.org/10.1055/s-0044-101254.

    Article  PubMed  Google Scholar 

  64. Cosgrove D, Piscaglia F, Bamber J, Bojunga J, Correas JM, Gilja OH, et al. EFSUMB guidelines and recommendations on the clinical use of ultrasound elastography. Part 2: clinical applications. Ultraschall Med. 2013;34(3):238–53. https://doi.org/10.1055/s-0033-1335375.

    Article  CAS  PubMed  Google Scholar 

  65. Rustemovic N, Cukovic-Cavka S, Brinar M, Radic D, Opacic M, Ostojic R, et al. A pilot study of transrectal endoscopic ultrasound elastography in inflammatory bowel disease. BMC Gastroenterol. 2011;11:113. https://doi.org/10.1186/1471-230X-11-113.

    Article  PubMed  PubMed Central  Google Scholar 

  66. Philips CA, Augustine P. Endoscopic ultrasound-guided Management of Bleeding Rectal Varices. ACG Case Rep J. 2017;4:e101. https://doi.org/10.14309/crj.2017.101.

    Article  PubMed  PubMed Central  Google Scholar 

  67. Shudo R, Yazaki Y, Sakurai S, Uenishi H, Yamada H, Sugawara K. Clinical study comparing bleeding and nonbleeding rectal varices. Endoscopy. 2002;34(3):189–94. https://doi.org/10.1055/s-2002-20289.

    Article  CAS  PubMed  Google Scholar 

  68. El-Saadany M, Jalil S, Irisawa A, Shibukawa G, Ohira H, Bhutani MS. EUS for portal hypertension: a comprehensive and critical appraisal of clinical and experimental indications. Endoscopy. 2008;40(8):690–6. https://doi.org/10.1055/s-2008-1077400.

    Article  CAS  PubMed  Google Scholar 

  69. Sharma M, Rai P, Bansal R. EUS-assisted evaluation of rectal varices before banding. Gastroenterol Res Pract. 2013;2013:619187. https://doi.org/10.1155/2013/619187.

    Article  PubMed  PubMed Central  Google Scholar 

  70. Sato T, Yamazaki K, Toyota J, Karino Y, Ohmura T, Akaike J. Diagnosis of rectal varices via color Doppler ultrasonography. Am J Gastroenterol. 2007;102(10):2253–8. https://doi.org/10.1111/j.1572-0241.2007.01340.x.

    Article  PubMed  Google Scholar 

  71. Sunkara T, Caughey ME, Culliford A, Gaduputi V. Idiopathic isolated colonic varices: an extremely rare condition. J Clin Med Res. 2018;10(1):63–5. https://doi.org/10.14740/jocmr3230w.

    Article  PubMed  Google Scholar 

  72. • Wald A, Bharucha AE, Cosman BC, Whitehead WE. ACG clinical guideline: management of benign anorectal disorders. Am J Gastroenterol. 2014;109(8):1141–57. https://doi.org/10.1038/ajg.2014.190 (quiz) 058. Useful guidelines for the evaluation of benign anorectal disorders.

    Article  PubMed  Google Scholar 

  73. Bharucha AE, Fletcher JG, Harper CM, Hough D, Daube JR, Stevens C, et al. Relationship between symptoms and disordered continence mechanisms in women with idiopathic faecal incontinence. Gut. 2005;54(4):546–55. https://doi.org/10.1136/gut.2004.047696.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  74. Richter HE, Fielding JR, Bradley CS, Handa VL, Fine P, FitzGerald MP, et al. Endoanal ultrasound findings and fecal incontinence symptoms in women with and without recognized anal sphincter tears. Obstet Gynecol. 2006;108(6):1394–401. https://doi.org/10.1097/01.AOG.0000246799.53458.bc.

    Article  PubMed  Google Scholar 

  75. Wang Z, Hu L, Jin X, Li X, Xu L. Evaluation of postoperative anal functions using endoanal ultrasonography and anorectal manometry in children with congenital anorectal malformations. J Pediatr Surg. 2016;51(3):416–20. https://doi.org/10.1016/j.jpedsurg.2015.09.024.

    Article  PubMed  Google Scholar 

  76. • Ramesh J, Bang JY, Trevino J, Varadarajulu S. Comparison of outcomes between endoscopic ultrasound-guided transcolonic and transrectal drainage of abdominopelvic abscesses. J Gastroenterol Hepatol. 2013;28(4):620–5. https://doi.org/10.1111/jgh.12081 In a retrospective study, the treatment of abdominopelvic abscess under EUS guidance through the transrectal or transcolonic routes was effective and safe.

    Article  PubMed  Google Scholar 

  77. Varadarajulu S, Drelichman ER. EUS-guided drainage of pelvic abscess (with video). Gastrointest Endosc. 2007;66(2):372–6. https://doi.org/10.1016/j.gie.2007.02.054.

    Article  PubMed  Google Scholar 

  78. Luigiano C, Togliani T, Cennamo V, Maimone A, Polifemo AM, Pilati S, et al. Transrectal endoscopic ultrasound-guided drainage of pelvic abscess with placement of a fully covered self-expandable metal stent. Endoscopy. 2013;45(Suppl 2 UCTN):E245–6. https://doi.org/10.1055/s-0032-1326250.

    Article  PubMed  Google Scholar 

  79. Choi EK, Kim JH, Jeong SU, Na SY, Boo SJ, Kim HU, et al. Endoscopic ultrasound-guided perirectal abscess drainage without drainage catheter: a case series. Clin Endosc. 2017;50(3):297–300. https://doi.org/10.5946/ce.2016.123.

    Article  PubMed  PubMed Central  Google Scholar 

  80. • Poincloux L, Caillol F, Allimant C, Bories E, Pesenti C, Mulliez A, et al. Long-term outcome of endoscopic ultrasound-guided pelvic abscess drainage: a two-center series. Endoscopy. 2017;49(5):484–90. https://doi.org/10.1055/s-0042-122011 In a retrospecitve evaluation, the long-term success of pelvic drainage with plastic stents or lumen opposing metal stents through EUS was 86.5% at 64 months with 100% initial technical success.

    Article  PubMed  Google Scholar 

  81. Fabbri C, Luigiano C, Lisotti A, Cennamo V, Virgilio C, Caletti G, et al. Endoscopic ultrasound-guided treatments: are we getting evidence based--a systematic review. World J Gastroenterol. 2014;20(26):8424–48. https://doi.org/10.3748/wjg.v20.i26.8424.

    Article  PubMed  PubMed Central  Google Scholar 

  82. Trevino JM, Varadarajulu S. Initial experience with the prototype forward-viewing echoendoscope for therapeutic interventions other than pancreatic pseudocyst drainage (with videos). Gastrointest Endosc. 2009;69(2):361–5. https://doi.org/10.1016/j.gie.2008.09.021.

    Article  PubMed  Google Scholar 

  83. • Moningi S, Walker AJ, Malayeri AA, Rosati LM, Gearhart SL, Efron JE, et al. Analysis of fiducials implanted during EUS for patients with localized rectal cancer receiving high-dose rate endorectal brachytherapy. Gastrointest Endosc. 2015;81(3):765–9. https://doi.org/10.1016/j.gie.2014.11.004 e1. All 11 patients had technically successful fiducial placement prior to receiving radation for rectal cancer. All patients had successful surgical resection with no tumor involving the surgical margins following radiation and all were alive and free of progression at last follow-up.

    Article  PubMed  PubMed Central  Google Scholar 

  84. Dhadham GC, Hoffe S, Harris CL, Klapman JB. Endoscopic ultrasound-guided fiducial marker placement for image-guided radiation therapy without fluoroscopy: safety and technical feasibility. Endosc Int Open. 2016;4(3):E378–82. https://doi.org/10.1055/s-0042-100720.

    Article  PubMed  PubMed Central  Google Scholar 

  85. Yang J, Abdel-Wahab M, Ribeiro A. EUS-guided fiducial placement after radical prostatectomy before targeted radiation therapy for prostate cancer recurrence. Gastrointest Endosc. 2011;73(6):1302–5. https://doi.org/10.1016/j.gie.2011.01.045.

    Article  PubMed  Google Scholar 

  86. Yang J, Abdel-Wahab M, Ribeiro A. EUS-guided fiducial placement before targeted radiation therapy for prostate cancer. Gastrointest Endosc. 2009;70(3):579–83. https://doi.org/10.1016/j.gie.2009.03.001.

    Article  PubMed  Google Scholar 

  87. Garcia-Tsao G, Abraldes JG, Berzigotti A, Bosch J. Portal hypertensive bleeding in cirrhosis: risk stratification, diagnosis, and management: 2016 practice guidance by the American Association for the study of liver diseases. Hepatology. 2017;65(1):310–35. https://doi.org/10.1002/hep.28906.

    Article  PubMed  Google Scholar 

  88. • Sato T, Yamazaki K, Akaike J, Toyota J, Karino Y, Ohmura T. Retrospective analysis of endoscopic injection sclerotherapy for rectal varices compared with band ligation. Clin Exp Gastroenterol. 2010;3:159–63. https://doi.org/10.2147/CEG.S15401 In a review of patients undergoing therapy for rectal varices, 0% of patients who received sclerotherapy vs 26.7% of patients who underwent banding had recurrent bleeding from rectal varices ( p < 0.05).

    Article  PubMed  PubMed Central  Google Scholar 

  89. Weilert F, Shah JN, Marson FP, Binmoeller KF. EUS-guided coil and glue for bleeding rectal varix. Gastrointest Endosc. 2012;76(4):915–6. https://doi.org/10.1016/j.gie.2011.09.027.

    Article  PubMed  Google Scholar 

  90. Citrin D, Camphausen K, Wood BJ, Quezado M, Denobile J, Pingpank JF, et al. A pilot feasibility study of TNFerade biologic with capecitabine and radiation therapy followed by surgical resection for the treatment of rectal cancer. Oncology. 2010;79(5–6):382–8. https://doi.org/10.1159/000323488.

    Article  PubMed  Google Scholar 

  91. Mukewar S, Muthusamy VR. Recent advances in therapeutic endosonography for cancer treatment. Gastrointest Endosc Clin N Am. 2017;27(4):657–80. https://doi.org/10.1016/j.giec.2017.06.014.

    Article  PubMed  Google Scholar 

  92. Ibsen S, Schutt CE, Esener S. Microbubble-mediated ultrasound therapy: a review of its potential in cancer treatment. Drug Des Devel Ther. 2013;7:375–88. https://doi.org/10.2147/DDDT.S31564.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  93. Zhang X, Yang G, Zhang Y, Huang P, Qiu J, Sun Y, et al. An experimental research into endostatin microbubble combined with focused ultrasound for anti-tumor angiogenesis in colon cancer. Gastroenterol Rep (Oxf). 2014;2(1):44–53. https://doi.org/10.1093/gastro/got038.

    Article  Google Scholar 

  94. Lakhtakia S. Complications of diagnostic and therapeutic endoscopic ultrasound. Best Pract Res Clin Gastroenterol. 2016;30(5):807–23. https://doi.org/10.1016/j.bpg.2016.10.008.

    Article  PubMed  Google Scholar 

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  1. Division of Gastroenterology, Washington University School of Medicine, 660 South Euclid Ave., Campus Box 8124, Saint Louis, MO, 63110, USA

    Stephen Hasak & Vladimir Kushnir

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Stephen Hasak is funded through NIH/NIDDK (T32 DK 052574).

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Hasak, S., Kushnir, V. Rectal Endoscopic Ultrasound in Clinical Practice. Curr Gastroenterol Rep 21, 18 (2019). https://doi.org/10.1007/s11894-019-0682-9

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