Rectal polyp reaching the dentate line: underwater EMR without submucosal lift

Post written by Sauid Ishaq, FRCP from the Gastroenterology Department, Dudley Group Hospitals, Birmingham City University in Birmingham, United Kingdom and St George's University in Grenada, West Indies. In this video we demonstrate a novel technique of underwater endoscopic mucosal resection (UEMR) without submucosal lift of a low rectal recurrent polyp (90 mm) reaching the dentate line. …

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Holmium laser lithotripsy to manage complex biliary calculi

Post written by Jason Behary, MBBS, from the Department of Gastroenterology and Hepatology, St George Hospital and University of New South Wales, in Sydney, Australia. Digital per-oral cholangioscopy performed under combined endoscopic and fluoroscopic control allows visualization and treatment of large and difficult to remove intra- and extrahepatic biliary calculi. A 200-micron holmium laser lithotripsy fiber …

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ESD removal of submucosal embedded fish bone in the esophagus

Post written by Hon Chi Yip from the Division of Upper Gastrointestinal and Metabolic Surgery at Prince of Wales Hospital at the Chinese University of Hong Kong. This video demonstrated successful removal of a fish bone that was deeply embedded inside the submucosa of proximal esophagus using the endoscopic submucosal dissection (ESD) technique. This video …

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Managing GI bleeding from a created endoscopic omental patch

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 …

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“Underwater” ESD for superficial esophageal neoplasms

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 …

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Pancreatic pseudoaneurysm mimicking cystic neoplasm with worrisome features

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 …

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Stepwise endoscopic eradication of GAVE using detachable snare and band ligation

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 …

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Surgical clip removal using short-type single-balloon enteroscope

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 …

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Clinical Utility of Rapid On-site Cytopathology

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 …

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Demonstration of transoral gastric outlet reduction

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 …

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