Large-caliber metal stent controls entry site bleeding during EUS-guided drainage of walled-off necrosis

Post written by Radhika Chavan, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. A 35-year-old man, diagnosed with acute necrotizing pancreatitis 7 weeks ago, presented with abdominal pain and fever for 2 weeks. Evaluation showed mild leukocytosis with raised amylase and lipase levels. Endoscopic ultrasound (EUS) showed large walled-off necrosis (WON) with minimal …

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Suture pulley countertraction method reduces procedure time and technical demand of ESD

Post written by Hiroyuki Aihara, MD, PhD, from the Developmental Endoscopy Lab, Harvard Medical School, and Division of Gastroenterology, Hepatology and Endoscopy, Brigham and Women’s Hospital, Boston, Massachusetts, USA. The lack of reliable countertraction in endoscopic submucosal dissection (ESD) contributes to its technical demand and increased procedure time. In our previous ex vivo study, we …

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Per-oral endoscopic myotomy with endoscopic septum division

Post written by Zaheer Nabi, MD, DNB, from the Asian Institute of Gastroenterology, Hyderabad, India. In this video case, we describe per oral endoscopic myotomy (POEM) in a case of achalasia with large diverticulum at the lower end of esophagus. POEM was performed in the standard fashion. In addition, the septum between diverticulum and submucosal …

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Simultaneous detection and characterization of diminutive polyps with the use of AI

Post written by Yuichi Mori, MD, PhD, from the Digestive Disease Center, Showa University Northern Yokohama Hospital, Yokohama, Japan. We present a novel computer-aided system that enables automated polyp detection followed by immediate polyp characterization in a real-time fashion using an endocytoscope, a colonoscope with a function of 520-fold endomicroscopy (CF-H290ECI; Olympus Corp., Tokyo, Japan). …

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Step-by-step use of hemostatic powder

Post written by Andrew C. Storm, MD, from the Mayo Clinic College of Medicine and Science, Rochester, Minnesota, USA. Our video is meant to be used as a teaching tool, demonstrating the step-by-step use of hemostatic powder for GI hemorrhage. More specifically, malignancy-associated bleeding, as shown in this case, is difficult to manage endoscopically, and …

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Submucosal per-oral endoscopic myotomy for a large Zenker’s diverticulum

Post written by Valerio Balassone, MD, PhD, from the Universita Campus Bio-Medico di Roma, Rome, Italy. This is a preliminary experience with an innovative technique to treat large Zenker’s diverticulum. It demonstrates innovative tools and techniques to separate the mucosa from the septum in order to achieve a complete septum division without the concern of …

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A unique case of ileal Dieulafoy’s lesion diagnosed and treated by cap-assisted water immersion colonoscopy

Post written by Philip T. Chen, MD, FACG, from the United Gastroenterologists, Irvine, California, USA. We describe a case of an 83-year-old woman presenting with melena and anemia.  An actively bleeding ileal Dieulafoy’s lesion was found 30 cm proximal to the ileocecal valve (measurement based on withdrawal) and treated through colonoscopy with deep ileal intubation …

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Utility of video capsule endoscopy for longitudinal monitoring of Crohn’s disease activity in the small bowel

Post written by Gil Y. Melmed, MD, from the F Widjaja Inflammatory Bowel and Immunobiology Research Institute, Cedars Sinai Medical Center, Los Angeles, California, USA. We aimed to determine the utility of using video capsule endoscopy for serial evaluations of Crohn’s disease activity. While the literature has demonstrated good correlation between WCE and colonoscopy at …

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A case of hemobilia secondary to cancer of the gallbladder confirmed by cholangioscopy

Post written by Linda Zhang, MBBS, from the Department of Gastroenterology and Hepatology, St George Hospital, Kogarah, Australia. This article discusses the management of hemobilia due to gallbladder malignancy in a frail, elderly patient with multiple comorbidities, which limited the available therapies. Our patient was a 90-year-old female who presented with biliary obstruction and melaena. …

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Polyloop anchor technique to close large gastric fistula

Post written by Tarun Kaura, MD, from the Aurora St Luke’s Medical Center, Milwaukee, Wisconsin, USA. A 60-year-old female presented with acute pancreatitis complicated by large acute pancreatic fluid collection, which later formed a symptomatic pseudocyst. This was drained endoscopically by placing a lumen-apposing metal stent. Unfortunately, she developed gastric perforation requiring surgery. The patient …

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