Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, USA. An 87-year-old woman with multiple comorbidities was found to have a gigantic gastric polyp (11 × 8 cm) with a broad short stalk containing an area of irregular vascular patterns worrisome for high-grade dysplasia. Attempting polypectomy using an endoloop was challenging because of the …
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Endoscopic pyloric exclusion—EUS-guided gastrojejunostomy combined with endoscopic suturing and closure of the pylorus: a novel approach to failed surgical repair of a perforated duodenal ulcer
Post written by Kambiz Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe a novel endoscopic procedure that results in complete diversion of the gastric stream away from the duodenum and into the proximal jejunum. Duodenal bypass was achieved using a 2-step approach. Step 1 involved diverting the gastric stream into …
Novel simulator of endoscopic hemostasis with actual endoscope and devices
Post written by Takeshi Kanno, MD, PhD, from the Division of Gastroenterology, Tohoku University Graduate School of Medicine, and the Department of Education and Support for Regional Medicine, Tohoku University Hospital, Sendai, Japan. Simulators capable of reproducing spurting bleeding that can be used to acquire endoscopic hemostasis with actual devices in a clinical setting have been …
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Underwater EMR for the diagnosis of diffuse infiltrative gastric cancer
Post written by Yushi Kawakami, MD, from the Department of Gastrointestinal Oncology, Osaka International Cancer Institute, Osaka, Japan. It was suspected that a 75-year-old woman had advanced infiltrative gastric cancer. However, endoscopic forceps biopsy specimens did not reveal adenocarcinoma. She was referred to our institute for further examination and treatment. To obtain sufficient submucosal specimens, underwater …
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Emergent endoscopic submucosal dissection for a polypoid fibroadipose tumor accidentally disgorged from the mouth: an organ-preserving minimally invasive treatment
Post written by Yuki Morita, MD, and Toshiyuki Yoshio, MD, PhD, from the Department of Gastroenterology, Cancer Institute Hospital, Japanese Foundation for Cancer Research, Tokyo, Japan. An unusual, long polyp was detected extending from the hypopharynx to the lower thoracic esophagus of a patient. Polypoid fibroadipose tumors should be resected because they are occasionally malignant and …
Endoscopic adventitial dissection of a rectal GI stromal cell tumor
Post written by Hao Dang, BSc, and Jurjen J. Boonstra, MD, PhD, from the Department of Gastroenterology and Hepatology, Leiden University Medical Center, Leiden, The Netherlands. Endoscopic submucosal dissection has allowed the endoscopist to perform en bloc resection of various types of GI neoplasms, including subepithelial tumors (SETs). However, submucosal dissection is not feasible for SETs …
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Modified technique of peroral endoscopic myotomy using transnasal ultra-slim gastroscope in a child with achalasia cardia
Post written by Amol Bapaye, MD, FASGE, FJGES, from the Shivanand Desai Center for Digestive Disorders, Deenanath Mangeshkar Hospital and Research Center, Pune, India. An 18-month female child presented with failure to thrive and regurgitation for 1 year. She was diagnosed with type II achalasia cardia on high-resolution manometry, and peroral endoscopic myotomy (POEM) was planned. …
With a little help from my friends: percutaneously assisted internalization of a biliary drain
Post written by Jad AbiMansour, MD, from the Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota, USA. We present the use of a preexisting percutaneous transhepatic biliary drain to distend the left biliary system and facilitate the completion of EUS-guided hepaticogastrostomy (EUS-HG), successfully internalizing the drain. This case highlights a multidisciplinary, collaborative approach and a …
Endoscopic submucosal dissection of appendiceal lesions by using a novel adjustable traction device: A-TRACT-2
Post written by Louis-Jean Masgnaux, MR, from the Gastroenterology and Endoscopy Unit, Edouard Herriot Hospital, Hospices Civils de Lyon, Lyon, France. We describe the use of an adjustable endoscopic traction system, the A-TRACT-2, a handmade device that can be tightened during the procedure to increase the traction tension and greatly assist the operator in difficult cases …
Cognitive ERCP: decision making during successful retrieval of proximally migrated biliary stent
Post written by Arjun Chatterjee, MD, from the Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. A 56-year-old man presented with painless jaundice. A CT scan reported a pancreatic mass, and he underwent ERCP at an outside facility with the placement of a plastic biliary stent through distal biliary stricture and EUS-guided biopsy of …
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