Post written by Ashish Sharma, MD, and Robert J. Sealock, MD, from the Department of Gastroenterology & Hepatology at Baylor College of Medicine in Houston, Texas, USA. An 80-year-old male presented to the GI lab for an endoscopic retrograde cholangiopancreatography (ERCP) for gall stone pancreatitis and high probability of choledocholithiasis. He developed an iatrogenic duodenal …
Continue reading Managing GI bleeding from a created endoscopic omental patch
Post written by Tomofumi Akasaka from the Department of Gastrointestinal Oncology at Osaka Medical Center for Cancer and Cardiovascular Disease. In this study, we used a bipolar needle-knife with a water jet function (Jet B-knife; Zeon Medical, Tokyo, Japan). After a circumferential incision, as performed for conventional ESD, esophageal lumen was filled and submucosal injection with …
Continue reading “Underwater” ESD for superficial esophageal neoplasms
Post written by Matheus C. Franco, MD, from the Cleveland Clinic Foundation, in Cleveland, Ohio, USA. A 61-year-old female presented with poor appetite, weight loss, and diarrhea. CT scan from outside hospital showed no significant abnormalities. Further investigation with MRI revealed a 1.4 cm cystic lesion in the body of pancreas with wall thickness and enhancing …
Continue reading Pancreatic pseudoaneurysm mimicking cystic neoplasm with worrisome features
Post written by Andrew P Wright, MD and Anoop Prabhu, MD, from the University of Michigan Health System in Ann Arbor, Michigan, United States. We present a case of a 58-year-old man with decompensated cirrhosis and transfusion-dependent anemia with nodular gastric antral vascular ectasia (GAVE) refractory to multiple treatment sessions with mucosal ablative therapies that we …
Continue reading Stepwise endoscopic eradication of GAVE using detachable snare and band ligation
Post written by Hideaki Koga, MD and Akio Katanuma, MD from the Center for Gastroenterology at Teine-Keijinkai Hospital in Sapporo, Japan. A 76-year-old man who underwent laparoscopic cholecystectomy (LC) and pancreaticoduodenectomy presented with repeated cholangitis. CT showed mild dilation of the bile duct with an enhancing wall, and the surgical clips after LC located near …
Continue reading Surgical clip removal using short-type single-balloon enteroscope
Post written by Dr. Harry Aslanian from the Section of Digestive Diseases at Yale University. We thought it would be interesting for non-endosonographers to see how easily and quickly ROSE can provide diagnostic information. Among endosonographers, there is local variation in cytopathologists’ comfort level with pancreas cytology and variable interest in ROSE. While some centers have …
Continue reading Clinical Utility of Rapid On-site Cytopathology
Post written by Vivek Kumbhari, MD, at Johns Hopkins Hospital in Baltimore, Maryland, USA. Weight regain after Roux-en-Y gastric bypass (RYGB) is common and is partially attributable to dilatation of the gastrojejunostomy (GJ), which diminishes the restrictive capacity of RYGB. Endoscopic revision of dilated GJ, called transoral outlet reduction (TORe), has been proved effective in …
Continue reading Demonstration of transoral gastric outlet reduction
Dr. Roy J Mukkada, MD, DNB, from the Department of Gastroenterology & Hepatology, VPS Lakeshore Hospital, Kochi, Kerala, India, presents this video case. A 65-year-old man (an alcoholic and a smoker) presented with recurrent abdominal pain, weight loss, and loss of appetite. He was known to have had chronic calcific pancreatitis since 2014. CT of …
Continue reading EUS-guided coiling for bleeding duodenal collateral vessel
Gabriel D. Lang, MD, from the Division of Gastroenterology, Washington University, Saint Louis, Missouri, presents this video case. A 67-year-old female with locally advanced duodenal adenocarcinoma with previous metal biliary and enteral stents presented with jaundice. The cholangiogram demonstrated a complete obstruction at the proximal end of the stent. Multiple attempts to advance a variety …
Continue reading Completely obstructed bile duct? Let cholangioscopy guide the way
Saikiran Raghavapuram, MD, Mohit Girotra, MD, FACP, and Benjamin Tharian, MD, MRCP, FRACP, from the University of Arkansas for the Medical Sciences present this video case. We present a 63-year-old male with a history of orthotopic liver transplantation 3 years ago, who presented with cholestatic jaundice. Work up revealed severe stricture of proximal common bile …
Continue reading Successful management of ischemic cholangiopathy
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