Combined bridging and antegrade stent placement during transmural treatment for malignant hilar biliary obstruction in a patient with surgically altered anatomy

Post written by Hassan Atalla, MSc, and Hideyuki Shiomi, MD, PhD, from the Division of Gastroenterology, Department of Internal Medicine, Kobe University Graduate School of Medicine, Kobe, Japan, and Hepatology and Gastroenterology Unit, Department of Internal Medicine, Mansoura Faculty of Medicine, Mansoura University, Mansoura, Egypt. A 69-year-old woman who had undergone a distal gastrectomy combined …

Continue reading Combined bridging and antegrade stent placement during transmural treatment for malignant hilar biliary obstruction in a patient with surgically altered anatomy

EUS-guided gastrojejunostomy and hepaticogastrostomy for malignant duodenal and biliary obstruction

Post written by Kevin D. Platt, MD, and Ryan J. Law, DO, from the Division of Gastroenterology, University of Michigan, Ann Arbor, Michigan, USA. Our case describes a 59-year-old woman with metastatic ovarian cancer who presented with nausea with vomiting and jaundice secondary to a large mesenteric mass that was causing both gastric outlet and …

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Bilateral balloon expandable biodegradable stent (Y-stent) for postcholecystectomy perihilar biliary stricture

Post written by Sundeep Lakhtakia, MD, MNAMS, DM, FASGE, from the Department of Medical Gastroenterology, AIG Hospitals and Asian Institute of Gastroenterology, Hyderabad, Telangana, India. A young woman who had surgical choledocho-duodenostomy 5 years ago for biliary adverse events soon after cholecystectomy presented with biliary obstruction. MRCP revealed a smooth mid-CBD stricture, intra-hepatic stone with …

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EUS diagnosis of asymptomatic type III choledochal cyst

Post written by Mohannad Abou Saleh, MD, Catherine Vozzo, DO, and Prabhleen Chahal, MD, from the Department of Gastroenterology and Hepatology, Cleveland Clinic Foundation, Cleveland, Ohio. We describe the EUS diagnosis of a type IIIA choledochal cyst in an 81-year-old woman with a history of diabetes mellitus type II, hypertension, hyperlipidemia, GERD, and irritable bowel …

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Endoscopic negative pressure therapy for upper gastrointestinal leaks

Post written by Rami Archid, MD, from the Department of General, Visceral and Transplant Surgery, Eberhard-Karls-University Hospital, Tuebingen, Germany. A 61-year-old male patient was treated for Siewert type I gastroesophageal junction adenocarcinoma. Neoadjuvant chemotherapy using FLOT regimen (5-fluorouracil, leucovorin, oxaliplatin, docetaxel) with Trastuzumab was followed by esophagectomy with cervical esophagogastrostomy. On postoperative day 3, he …

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Single-step EUS-guided drainage of a pancreatic pseudocyst with a modified guidewire as a cystotome

Post written by Wei An, MD, Dan Wang, MD, and Liang-Hao Hu, MD, from the Department of Gastroenterology, ChangHai Hospital, The Second Military Medical University, Shanghai, China. A 69-year-old man with a history of chronic pancreatitis was referred to our hospital for severe abdominal distention and vomiting. Computed tomography revealed multiple pancreatic calcifications and a …

Continue reading Single-step EUS-guided drainage of a pancreatic pseudocyst with a modified guidewire as a cystotome

EUS diagnosis of rectal endometriosis

Post written by Bo Sun, MD, from the Department of Gastroenterology, Longhua Hospital, Shanghai University of Traditional Chinese Medicine, Shanghai, China. This case was a 40-year-old woman with a 2-month history of increased bowel movements and feelings of incomplete evacuation. Her colonoscopy detected a rectal submucosal elevation with unrevealing biopsy results. Pelvic MRI suggested a rectal …

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EUS-guided gastroenterostomy assisted by extrinsic abdominal compression to treat gastric obstruction after surgical resection of a GI stromal tumor

Post written by Michael Lajin, MD, from the Sharp Grossmont Hospital, La Mesa, California. EUS-guided gastroenterostomy is increasingly utilized to treat gastric outlet obstruction after surgery. We describe a case of EUS-guided gastroenterostomy facilitated by extrinsic abdominal compression to treat gastric obstruction following surgical resection of a gastrointestinal stromal tumor. A 77-year-old woman underwent laparoscopic resection of …

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Use of a new traction device to expose the base of a pedunculated appendiceal polyp

Post written by Hirosato Tamari, MD, from the Department of Endoscopy, Hiroshima University Hospital, Hiroshima, Japan. A 67-year-old man underwent a positron emission tomography/computed tomography (PET/CT) scan for thyroid cancer and was found to have an accumulation in the cecum (SUVmax value: 8.1) and in the thyroid gland. Colonoscopy revealed a pedunculated appendiceal polyp. The …

Continue reading Use of a new traction device to expose the base of a pedunculated appendiceal polyp

Colovaginal fistula closure using a cardiac septal defect occluder

Post written by Omar Sadiq, MD, from the Division of Gastroenterology, Henry Ford Hospital, Detroit, Michigan. We present a case of a 70-year-old woman who developed a colovaginal fistula following debulking surgery for stage 3 ovarian carcinoma. She refused further surgical intervention, and endoscopic interventions such as over-the-scope clips and endoscopic suturing were not successful. …

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