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 …
Tag: EUS
In vivo diagnosis of intraductal papillary mucinous neoplasm with per-oral pancreatoscopy–guided confocal laser endomicroscopy
Post written by Yuki Tanisaka, MD, PhD, from the Department of Gastroenterology, Saitama Medical University International Medical Center, Saitama, Japan. Our patient was a 79-year-old man in whom computed tomography indicated expansion of the main pancreatic duct. Endoscopic ultrasound (EUS) showed expansion of the entire pancreatic duct but could not detect the villous protrusions. Endoscopic …
Endoscopic intra-abdominal rescue therapy of a dislodged EUS-guided hepaticogastrostomy stent
Post written by Johannes Maubach, MD, from the Department of Visceral Surgery and Medicine, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland. We report a case of an 86-year-old fragile woman who was admitted with painless jaundice and massively congested intrahepatic ducts. An outside MRCP showed a suspicious lesion in the tail of the …
EUS-directed transgastric ERCP
Post written by Antonio Mendoza Ladd, MD, from the Department of Medicine, Division of Gastroenterology, Texas Tech University Health Sciences Center at El Paso, El Paso, Texas, USA. This is a case of a patient with impending ascending cholangitis secondary to choledocolithiasis in the setting of a Roux-en-Y anatomy. Given her surgical anatomy, we discussed …
Crossing the minefield: EUS-guided transesophageal biliary rendezvous
Post written by Sundeep Lakhtakia, MD, DM, from the Asian Institute of Gastroenterology, Hyderabad, India. An elderly male presented with obstructive jaundice due to malignant distal biliary obstruction related to pancreatic head mass. There was associated portal vein thrombosis causing portal cavernoma and large esophago-gastric varices along with ascites. Repeated attempts to drain the obstructed …
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EUS diagnosis of cystic pancreatic neuroendocrine tumors
Post written by Harry R. Aslanian, MD, from the Section of Digestive Disease, Yale New Haven Medical Center, School of Medicine, New Haven, Connecticut, USA. We present a series of cases highlighting the EUS features of cystic pancreatic neuroendocrine tumors. Pancreas neuroendocrine tumors are rare and are less commonly cystic. The recognition and targeting of wall …
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Electroacupuncture-reduced sedative and analgesic requirements for diagnostic EUS
Post written by Anthony Yuen Bun Teoh, FRCSEd, from the Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China. Acupuncture has been used as part of traditional Chinese medicine (TCM) for thousands of years. However, the role of electroacupuncture (EA) in reducing sedative and analgesic requirements …
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EUS evaluation of liver lesions
Post written by Muhammad Nadeem Yousaf, MD, and Harry R. Aslanian, MD, from the Department of Internal Medicine, Section of Digestive Diseases, Yale University School of Medicine, New Haven, Connecticut, USA. In our video case series, we present endoscopic ultrasound (EUS) imaging of common benign and malignant liver lesions. The cases presented include: liver cyst …
EUS imaging of dead Ascaris
Post written by Malay Sharma, MD, DM, from the Department of Gastroenterology, Jaswant Rai Speciality Hospital, Saket, Uttar Pradesh, India. A 4-year-old Indian boy presented with recurrent biliary colic and jaundice for 2 weeks. Laboratory investigations revealed obstructive jaundice. Abdominal ultrasonography (USG) revealed a normal gallbladder, intrahepatic biliary radicles dilation, and a dilated common bile …
Successful obliteration of bleeding duodenal varices by EUS-guided injection of N-butyl-2-cyanoacrylate
Post written by Yusuke Hashimoto, MD, from the Department of Hepatobiliary and Pancreatic Oncology, National Cancer Center Hospital East, Kashiwa, Japan. This case describes a 76-year-old woman with unresectable pancreatic head cancer who presented with hematemesis that was complicated by multinodular duodenal varices originating from a posterior lower pancreatic vein viewed on CT scan. Banding …