Transpapillary nasocystic tube placement to allow gallbladder distention for EUS-guided cholecystoduodenostomy

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We describe a 39-year-old woman with a history of Crohn’s disease and multiple bowel resections who presented with 2.5 months of right upper-quadrant pain and found to have multiple gallstones and cystic …

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Comparative accuracy of needle sizes and designs for EUS tissue sampling of solid pancreatic masses

Post written by Antonio Facciorusso, MD, PhD, from the Endoscopy Unit, University of Foggia, Foggia, Italy. EUS-guided tissue acquisition (EUS-TA) for cytology through fine-needle aspiration (FNA) or fine-needle biopsy (FNB) using specialized core needles has become a central technique in the assessment of pancreatic masses. The most important pitfall associated with this procedure is a …

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Nonampullary duodenal subepithelial neuroendocrine tumor removed R0 by ESD

Post written by Borathchakra Oung, MD, from the Department of Endoscopy and Gastroenterology, Edouard Herriot Hospital, Lyon, France. Managing lesions endoscopically in the duodenum can be challenging due to its thin wall and anatomically narrow lumen that limit endoscope maneuver. We reported a case of a subepithelial neuroendocrine tumor located in duodenal bulb just behind …

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Endoscopic unroofing drainage with a needle-knife for gastric wall abscess

Post written by Yusuke Hashimoto, MD, from the Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. This case describes a 68-year-old diabetic woman was referred for evaluation of a pancreatic tail mass (maximum diameter, 3.2 cm). To obtain specimens for histologic examination before neoadjuvant chemotherapy, transgastric EUS-FNA was performed with …

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Lesser curve approach to gastric peroral endoscopic myotomy

Post written by Danny Issa, MD, from the Division of Gastroenterology and Hepatology, Weill Cornell Medicine/New York, Presbyterian Hospital, New York, New York, USA. We performed gastric peroral endoscopic myotomy (GPOEM) using a lesser curve approach on 3patients with severe gastroparesis refractory to medical therapy. Two of the patients had undergone prior GPOEM with the …

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Intraperitoneal echoendoscopy for rescue of a gastrojejunal anastomosis

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We describe our experience rescuing a maldeployed lumen-apposing metal stent (LAMS) by passing an endoscopic ultrasound scope through the proximal end of the stent and re-puncturing the target bowel from within the …

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Contributing factors to an outbreak of multidrug-resistant K pneumoniae

Post written by Arjan W. Rauwers, MD, from the Department of Gastroenterology and Hepatology, Erasmus MC University Medical Center, Rotterdam, The Netherlands. Worldwide, an increasing number of duodenoscope-associated outbreaks are reported. The contributing factors to an outbreak are not well understood. We report on an investigation after the outbreak of a multidrug-resistant Klebsiella pneumoniae (MRKP) …

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Stent-in-stent self-expandable metallic stent placement under direct cholangioscopy

Post written by Mitsuru Okuno, MD, PhD, from the Department of Gastroenterology, Gifu Municipal Hospital, Gifu, Japan. Managing consequent jaundice caused by malignant hilar biliary obstruction (MHBO) is important. Endoscopic biliary drainage is the treatment of choice because of its limited invasiveness. However, in patients with surgically altered anatomy, especially those who have undergone Roux-en-Y …

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EUS-guided enterocolostomy for palliation of malignant distal small-bowel obstruction

Post written by Shelini Sooklal, MD, and Anand Kumar, MD, MPH, from the Division of Gastroenterology, Drexel University College of Medicine, Philadelphia, Pennsylvania, USA. Our video case describes the implementation of a therapeutic endoscopic ultrasound (EUS) technique to provide palliative relief of recurrent small bowel obstruction in a patient with metastatic adenocarcinoma of the colon …

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Improvement in colonoscopy quality metrics in clinical practice

Post written by Simon C. Mathews, MD, from the Johns Hopkins University School of Medicine, Department of Medicine, Division of Gastroenterology and Hepatology, and the Johns Hopkins Medicine Armst.rong Institute for Patient Safety and Quality, Baltimore, Maryland, USA. Our basic aim was to determine whether metrics for colonoscopy quality have improved over time. Research, education, …

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