Tissue retractor system–assisted ESD of a large rectal tumor with significant fibrosis

Post written by Salmaan Jawaid, MD, from the Division of Gastroenterology, Hepatology and Nutrition, University of Florida Health, Gainesville, Florida, USA. With the assistance of a novel tissue retractor system, we successfully performed endoscopic submucosal dissection (ESD) of a large rectal lesion that had developed significant fibrosis from direct tattoo material. Typically, performing ESD of …

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Recalcitrant embedded biliary self-expanding metal stents

Post written by Marc Bernon, MB, ChB, FCS, from the Surgical Gastroenterology Unit, Division of General Surgery, University of Cape Town Health Sciences Faculty and Groote Schuur Hospital, Cape Town, South Africa. Endoscopic placement of self-expanding metal stents (SEMS) is the palliative treatment of choice for obstructive jaundice due to malignant biliary obstruction. However, a …

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EUS-guided gastrojejunostomy for relief of gastric outlet obstruction from a large duodenal hematoma

Post written by Theodore W. James, MD, from the Division of Gastroenterology and Hepatology, University of North Carolina, Chapel Hill, North Carolina, USA. We present the first reported use of an EUS-guided gastrojejunostomy for the treatment of gastric outlet obstruction from a large duodenal hematoma. A 44-year-old man with a history of alcoholic pancreatitis presented …

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Minimal water exchange colonoscopy

Post written by Jen-Hao Yeh, MD, and Hsi-Yuan Chien, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, E-DA Hospital/I-shou University, Kaohsiung, and the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Taiwan Adventist Hospital, Taipei, Taiwan. Water colonoscopy is very useful to reduce pain and facilitate intubation for difficult colons. …

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Endoscopic tunneled stricturotomy in the treatment of stenosis after sleeve gastrectomy

Post written by Diogo Turiani Hourneaux de Moura, MD, MSc, PhD, from the Brigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA. We present a case of a 22-year-old obese woman with a history of laparoscopic sleeve gastrectomy. The surgery was uncomplicated; however, the patient was slow in advancing her diet. For the first …

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Endoscopic closure of the defect after ESD with metal clips and surgical sutures

Post written by Zhendong Jin, MD, from the Department of Gastroenterology, Changhai Hospital Affiliated to the Second Military Medical University, Shanghai, China. A patient accepted ESD for a SMT originated from the muscularis propria layer, which was located at the anterior wall of the gastric body. In consideration of muscular injury, the large defect was …

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Endoscopic full thickness resection of a long intussuscepted appendix using a colonoscope

Post written by Ghassan M. Hammoud, MD, MPH, from the Division of Gastroenterology and Hepatology, University of Missouri School of Medicine, Columbia, Missouri, USA. The cecum is cleansed and irrigated with water thoroughly. The inverted appendix is captured at its base with endoscopic detachable snares. We used 3detachable snares to ensure sufficient closure of the …

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