A challenging case of gastric endoscopic submucosal dissection

Post written by Seiichiro Abe, MD, PhD, from the Endoscopy Division, National Cancer Center Hospital, Tokyo, Japan. A 62-year-old woman underwent screening esophagogastroduodenoscopy, and a suspicious 80-mm elevated, laterally spreading lesion was found involving the greater curvature of the upper gastric body. Biopsy showed well-differentiated tubular adenocarcinoma. The patient opted for endoscopic submucosal dissection (ESD). …

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Use of multiple covered metal esophageal stents for treatment of Boerhaave syndrome in achalasia

Post written by Theodore W. James, MD, MSc, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We describe the case of a 95-year old-woman with known achalasia who presented after vomiting forcefully and developing a perforation of the esophagus, also known as Boerhaave syndrome. In most scenarios, …

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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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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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