Endoscopic ultrasound gastroenterostomy: how to avoid inadvertent gastrocolostomy

Endoscopic ultrasound (EUS)-guided gastroenterostomy (EUS-GE) is a commonly used modality in patients with gastric outlet obstruction, with results equivalent to surgical gastrojejunostomy [1] [2]. Inadvertent gastrocolostomy is a rare but major complication of EUS-GE [3]. As the transverse colon is a mobile structure, it can overlap the jejunal loop, and failure to identify this can lead to inadvertent gastrocolostomy [3].