Post written by Carlos Robles-Medranda, MD, from the Instituto Ecuatoriano de Enfermedades Digestivas (IECED), Guayaquil, Ecuador. We present a case study of an unilocular collection in the sixth segment of the liver that persisted after treatment with broad-spectrum antibiotic therapy. Because of comorbidities, full-dose anticoagulation, and high cardiovascular, surgical, and bleeding risks of percutaneous drainage, the …
Category: VideoGIE
Troubleshooting impaction of a pancreatoscopy-guided retrieval basket during pancreatic duct stone removal
Post written by Samuel Han, MD, MS, from The Ohio State University Wexner Medical Center, Columbus, Ohio, USA. We describe a case of pancreatoscopy-guided removal of a pancreatic duct stone. As electrohydraulic lithotripsy (EHL) was unsuccessful in fragmenting the large pancreatic duct stone, we used a cholangiopancreatoscopy-specific basket device to capture the stone. During removal of …
Intra-ampullary papillary-tubular neoplasm
Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the University of California Davis School of Medicine, Sacramento, California, and Texas Digestive Disease Consultants, The Woodlands, Texas, USA. A 63-year-old woman had incidentally noted abnormal liver test results with transaminitis (aspartate aminotransferase 104 U/L, alanine transaminase 233 U/L), elevated alkaline phosphatase (290 U/L), and mild hyperbilirubinemia (total …
Endoscopic lithotripsy of a gallstone impacted in lumen-apposing metal stent positioned for cholecysto-gastrostomy
Post written by Mauro Manno, MD, from the Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy. EUS-guided gallbladder drainage with a lumen-apposing metal stent (LAMS) is a viable treatment option for acute cholecystitis and an alternative to cholecystectomy in patients at high risk for surgery. However, recurrent acute cholecystitis with stone impaction in the LAMS can …
Double-balloon enteroscopy with EUS-guided rendezvous for failed cannulation in patients with history of Roux-en-Y gastric bypass
Post written by Kambiz S. Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe 2 patients with Roux-en-Y gastric bypass (RYGB) who underwent double-balloon enteroscopy—assisted ERCP (DBE-ERCP) for the management of pancreatolithiasis and choledocholithiasis. After reaching the ampulla, deep cannulation of the bile duct could not be achieved using the enteroscope. …
Circumferential endoscopic submucosal dissection of distal rectal polyp in a patient with portal hypertension complicated by bowel obstruction
Post written by Siddharth B. Javia, MD, from Confluence Health, Wenatchee, Washington, USA. Our video demonstrates a technique for circumferential endoscopic submucosal dissection (ESD) without using any traction accessories. This was performed in a patient who had significant scarring from Crohn’s colitis and portal hypertension with large blood vessels in the submucosa, which made ESD challenging. …
Primary leiomyosarcoma of the pancreas with metastasis to the spleen
Post written by Philippe Willems, MD, from the Center for Advanced Endoscopy, Research & Education, Orlando Health Digestive Health Institute, Orlando, Florida, USA. A 46-year-old woman was evaluated in the endoscopy unit for intermittent epigastric pain. On EUS examination, a large, hypoechoic, and irregular mass was found in the pancreas, and a similar 6-cm lesion was …
Continue reading Primary leiomyosarcoma of the pancreas with metastasis to the spleen
Usefulness of texture- and color-enhancement imaging for identifying the bleeding point in a patient with post–endoscopic sphincterotomy bleeding
Post written by Yuki Tanisaka, MD, PhD, from Saitama Medical University International Medical Center, Saitama, Japan. A 61-year-old woman was referred to our hospital for obstructive jaundice because of unresectable pancreatic cancer. We performed endoscopic sphincterotomy before fully covered self-expandable metallic stent placement. The following day, the patient presented with tarry stools. Endoscopic examination was performed …
Long per-rectal endoscopic myotomy for a case of Hirchsprung’s disease
Post written by Akshay Kulkarni, DM, from Midas Multi-Specialty Hospital, Nagpur, India. This video case shows the procedure of per-rectal endoscopic myotomy (PREM) for a case of Hirchsprung’s disease. It was a particularly difficult case requiring a long (25 cm) myotomy, and a delayed perforation complicated recovery. However, it was successfully managed endoscopically, and the patient …
Continue reading Long per-rectal endoscopic myotomy for a case of Hirchsprung’s disease
Deploying automated machine learning for computer vision projects: a brief introduction for endoscopists
Post written by Neal Mahajan, ScB, from the Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, and Indiana University School of Medicine, Indianapolis, Indiana, USA. Our team has worked for several years on the use of machine learning (ML) in endoscopy and helped validate its additive effect in the endoscopy suite. We have noticed …
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