Post written by Kenneth J. Chang, MD, from the Digestive Health Institute, Chao Family Comprehensive Digestive Disease Center, University of California, Irvine. These are 2 cases of EUS-guided liver biopsy where there was active blood flow within the needle tract prior to needle withdrawal. After waiting 2-3 minutes, we saw persistent flow, raising concerns that …
Continue reading EUS-guided blood patch delivery during liver biopsy: nature’s gel foam
Post written by Manol Jovani, MD, MPH, from the Division of Gastroenterology and Hepatology, Johns Hopkins Hospital, Baltimore, Maryland. Biliopancreatic diversion (also known as duodenal switch) is a complex bariatric surgery that includes a sleeve gastrectomy and long Roux-en-Y intestinal bypass. This is a very effective surgery for weight loss, but it can be complicated …
Continue reading Switching the switch: endoscopic reversal of a biliopancreatic diversion
Post written by Toshiyasu Shiratori, MD, from the Department of Gastroenterology, Kameda Medical Center, Kamogawa City, Japan. This video shows an endoscopic pancreatic duct drainage technique combining ERCP with EUS using a percutaneous drainage route for main pancreatic duct disconnection that was difficult to traverse through the disconnected segment using either ERCP- or EUS-guided approaches. …
Post written by Hiroyuki Aihara, MD, PhD, FASGE, from the Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts. This case video demonstrates a hybrid endoscopic submucosal dissection (ESD) with a novel ESD knife, followed by mucosal defect closure using an innovative endoscopic helix tacking system. A 60-year-old man …
Post written by Kayla M. Hartz, DO, from the Department of Internal Medicine, Penn State Health Milton S. Hershey Medical Center, Hershey, Pennsylvania. These are 2 cases in which hemostatic spray was used as a bail-out method for hemostasis when other standard methods failed. These cases show the value in using a hemostatic spray as …
Post written by Ahmed Altonbary, MD, FRCP, from the Department of Gastroenterology and Hepatology, Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. We describe a case of EUS-guided ethanol ablation (EA) of metastatic functional insulinoma in a young male with recurrent attacks of hypoglycemia requiring intravenous glucose infusion. Management of functioning pancreatic NETs is challenging; …
Continue reading EUS-guided ethanol ablation of metastatic functional insulinoma
Post written by Takafumi Maruyama, MD, Takashi Murakami, MD, PhD, Yoichi Akazawa, MD, PhD, Tomoyoshi Shibuya, MD, PhD, and Akihito Nagahara, MD, PhD, from the Department of Gastroenterology, Juntendo University School of Medicine, Tokyo, Japan. Here, we present a case of improved visibility with gel immersion in the presence of ongoing bleeding during colorectal endoscopic …
Post written by Jerome D. Waye, MD, from the Department of Gastroenterology, Icahn School of Medicine at Mount Sinai, New York, New York. This is the first report of training doctors to adequately perform endoscopy using the internet. We used the internet to teach endoscopy with the trainee in Uganda and the instructor in New York. …
Continue reading Remote training in flexible gastrointestinal endoscopy
Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. This is a case series of 5 patients, demonstrating several unique and varied benign features of PSC. We describe a novel phenotypic classification of benign features, whereby we categorize findings into …
Continue reading Cholangioscopy in primary sclerosing cholangitis
Post written by Sooraj Tejaswi, MD, MSPH, from the Division of Gastroenterology & Hepatology, University of California Davis School of Medicine, Sacramento, California. We describe the collaborative effort of the use of the novel short cholangioscope-aided percutaneous retrieval of a plastic biliary stent after being unable to retrieve the stent during ERCP. The patient was …
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