Clinical Utility of Rapid On-site Cytopathology

Post written by Dr. Harry Aslanian from the Section of Digestive Diseases at Yale University. We thought it would be interesting for non-endosonographers to see how easily and quickly ROSE can provide diagnostic information. Among endosonographers, there is local variation in cytopathologists’ comfort level with pancreas cytology and variable interest in ROSE. While some centers have …

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Demonstration of transoral gastric outlet reduction

Post written by Vivek Kumbhari, MD, at Johns Hopkins Hospital in Baltimore, Maryland, USA.  Weight regain after Roux-en-Y gastric bypass (RYGB) is common and is partially attributable to dilatation of the gastrojejunostomy (GJ), which diminishes the restrictive capacity of RYGB. Endoscopic revision of dilated GJ, called transoral outlet reduction (TORe), has been proved effective in …

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Impact of carbon dioxide insufflation and water exchange on postcolonoscopy outcomes

Post written by Sergio Cadoni from the Digestive Endoscopy Unit at St. Barbara Hospital in Iglesias, Italy. Water exchange (WE) is the least painful insertion method during colonoscopy. However, its impact on postcolonoscopy discomfort has not been well-described. Carbon dioxide (CO2) insufflation has been consistently shown to decrease postcolonoscopy discomfort. We compared postcolonoscopy outcomes of various combinations …

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EUS-guided coiling for bleeding duodenal collateral vessel

Dr. Roy J Mukkada, MD, DNB, from the Department of Gastroenterology & Hepatology, VPS Lakeshore Hospital, Kochi, Kerala, India, presents this video case. A 65-year-old man (an alcoholic and a smoker) presented with recurrent abdominal pain, weight loss, and loss of appetite. He was known to have had chronic calcific pancreatitis since 2014. CT of …

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Completely obstructed bile duct? Let cholangioscopy guide the way

Gabriel D. Lang, MD, from the Division of Gastroenterology, Washington University, Saint Louis, Missouri, presents this video case. A 67-year-old female with locally advanced duodenal adenocarcinoma with previous metal biliary and enteral stents presented with jaundice. The cholangiogram demonstrated a complete obstruction at the proximal end of the stent. Multiple attempts to advance a variety …

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EUS-guided fine needle biopsy sampling using a novel fork-tip needle

Post written by Pujan Kandel, MD, from the Division of Gastroenterology, Mayo Clinic, Jacksonville, Florida. This was a single center retrospective case control study. All the consecutive samples from EUS-FNB-SCs were matched in a 1:3 ratio by the lesion site (e.g. pancreatic head) and needle gauge (i.e. 19, 22, and 25 gauge) to recent random …

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Successful management of ischemic cholangiopathy

Saikiran Raghavapuram, MD, Mohit Girotra, MD, FACP, and Benjamin Tharian, MD, MRCP, FRACP, from the University of Arkansas for the Medical Sciences present this video case. We present a 63-year-old male with a history of orthotopic liver transplantation 3 years ago, who presented with cholestatic jaundice. Work up revealed severe stricture of proximal common bile …

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The use of hemostatic spray as an adjunct to conventional hemostatic measures

Post written by Rohit Sinha, MBBS, MRCP, PgDip, from the Royal Infirmary and The University of Edinburgh, Edinburgh, United Kingdom. We wanted to evaluate the efficacy of Hemospray in conjunction with established hemostatic endo-therapy in a high-risk nonvariceal upper GI bleeding setting. There was no evidence about the efficacy and outcome of combination therapy (Hemospray …

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Mating Ancylostoma Duodenale under Magnifying Endoscopy

Ming-Yan Cai, MD, from the Endoscopy Center and Endoscopy Research Institute, Zhongshan Hospital, Fudan University, Shanghai, China, presents this video case. During a regular EGD exam, using a magnifying scope with narrow-band imaging (NBI) function, we observed a very interesting pattern of Ancylostoma duodenale. A male worm was coiled around a female one and the …

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Molecular cytology genotyping of primary and metastatic GI stromal tumors

Post written by Ferga C. Gleeson, MD, from the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota. In patients with either primary or metastatic sporadic GI stromal tumors, we sought to determine the frequency of KIT and PDGFRA pathogenic alterations within paired endoscopic ultrasound cytology smears and surgical pathology specimens, Imatinib sensitivity, and the …

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