Post written by Sardar Momin Shah-Khan, MD, from the Section of Gastroenterology and Hepatology, West Virginia University, Morgantown, West Virginia, USA.

We present the case of a patient referred for EUS evaluation of a submucosal lesion at the appendiceal orifice.

We used a double-balloon endoluminal intervention platform to perform both radial and linear EUS with fine-needle biopsy of the submucosal lesion.

Sonographic assessment and pathology demonstrated the lesion to be a leiomyoma, and the patient was able to avoid unnecessary surgery.

Although EUS is frequently used in the distal colon and rectum, its use in the right colon is technically challenging owing to the oblique optics of the echoendoscope.

In our case, we highlighted that the double-balloon endoluminal intervention platform can facilitate the passage of both a radial echoendoscope (Olympus, Center Valley, Pa, USA) and a curved linear array echoendoscope (Olympus) into the cecum. This allows endoscopists to perform both a sonographic assessment and fine-needle biopsy at the areas of interest in the proximal colon.

This case features the evaluation of a submucosal lesion, but use of this technique is reproducible throughout the entirety of the colon. With the use of a double-balloon endoluminal intervention platform, both radial and linear EUS with fine-needle biopsy can be performed anywhere in the colon. Use of this technique can be considered when the appropriate clinical scenario arises.

CT imaging demonstrating soft tissue density at the cecum.

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