Successful endoscopic management of a malignant gastroretroperitoneal fistula

Post written by Ali Alshati, MD, from the Department of Internal Medicine, Maricopa Integrated Health System, Creighton University, Phoenix, Arizona, USA. This is a case of a gastric fistula due to involvement with lymphoma that was successfully managed endoscopically and then with systemic therapy. Endoscopic closure consisted of ablation of the fistula track with argon …

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Hemospray hemostasis in bleeding diffusely ulcerated esophagus

Post written by Shou-jiang Tang, MD, from the Division of Digestive Diseases, Department of Medicine, University of Mississippi Medical Center, Jackson, Mississippi, USA. The authors present 3 consecutive cases of diffusely ulcerated esophagus with clinically significant bleeding. The first 2 cases failed conventional hemostatic treatment including clipping and injection therapy. In the third case, hemospray …

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Treatment of an epiphrenic diverticulum

Post written by Vincent Huberty, MD, from the Department of Gastroenterology, Hepatopancreatology, and Digestive Oncology, Erasme Hospital, Université Libre de Bruxelles, Brussels, Belgium. This video case shows the treatment of an epiphrenic diverticulum with a new suturing and cutting technique. The treatment is done in 2 phases. First we placed suture anchors between the bottom …

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Tissue retractor system–assisted ESD of a large rectal tumor with significant fibrosis

Post written by Salmaan Jawaid, MD, from the Division of Gastroenterology, Hepatology and Nutrition, University of Florida Health, Gainesville, Florida, USA. With the assistance of a novel tissue retractor system, we successfully performed endoscopic submucosal dissection (ESD) of a large rectal lesion that had developed significant fibrosis from direct tattoo material. Typically, performing ESD of …

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Recalcitrant embedded biliary self-expanding metal stents

Post written by Marc Bernon, MB, ChB, FCS, from the Surgical Gastroenterology Unit, Division of General Surgery, University of Cape Town Health Sciences Faculty and Groote Schuur Hospital, Cape Town, South Africa. Endoscopic placement of self-expanding metal stents (SEMS) is the palliative treatment of choice for obstructive jaundice due to malignant biliary obstruction. However, a …

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EUS-guided gastrojejunostomy for relief of gastric outlet obstruction from a large duodenal hematoma

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We present the first reported use of an EUS-guided gastrojejunostomy for the treatment of gastric outlet obstruction from a large duodenal hematoma. A 44-year-old man with a history of alcoholic pancreatitis presented …

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Minimal water exchange colonoscopy

Post written by Jen-Hao Yeh, MD, and Hsi-Yuan Chien, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA Hospital/I-shou University, Kaohsiung, and the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan. Water colonoscopy is very useful to reduce pain and facilitate intubation for difficult colons. …

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