Post written by Radhika Chavan, MD, DNB, FASGE, FISG, from Ansh Clinic, Ahmedabad, Gujarat, India. In our article, we demonstrate the techniques of EUS-guided embolization of various vascular lesions, including gastric varices, ectopic varices, and pseudoaneurysms. We discuss 2 methods of EUS-guided embolization for gastric varices: (1) direct puncture of the varices and (2) feeder vessel …
Continue reading Technical tips for EUS-guided embolization of varices and pseudoaneurysms
Post written by Michael Lajin, MD, from Sharp HealthCare, San Diego, California, USA. A 64-year-old woman with a history of perforated goblet cell carcinoid tumor of the appendix underwent extensive cytoreductive surgery with heated intraperitoneal chemotherapy 5 years prior. She had a recent small-bowel obstruction requiring exploratory laparotomy with extensive lysis of adhesions and resection of …
Continue reading Retrograde EUS-guided ileocolostomy for malignant small-bowel obstruction
Post written by Kambiz Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. Main duct—type intraductal pancreatic mucinous neoplasms (IPMNs) present a diagnostic and management challenge, requiring careful evaluation to accurately determine the extent of the disease and guide treatment decisions. Preoperative or intraoperative pancreatoscopy proves to be invaluable when assessing the extent …
Post written by Wataru Yoshioka, MD, from Kameda Medical Center, Kamogawa, Japan. A new double soft-tipped guidewire (GW) that has 2 angulated tips with hydrophilic coating on both ends (RevoWave DualMaster, 0.025 inches, 450 cm long; Piolax Medical Devices, Inc, Yokohama, Japan) has been recently developed. This GW enables simultaneous cannulation of the pancreatic and bile …
Post written by Deepak Madhu, MD, MRCP, DM, from NTT Medical Center Tokyo, Tokyo, Japan. An 83-year-old man with severe comorbidities underwent endoscopic submucosal dissection for early gastric cancer. Histologic analysis of the resected specimen showed that vertical margins were positive, and the tumor had deep submucosal invasion. In light of severe comorbidities, a multidisciplinary decision …
Post written by Takaoki Hayakawa, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, School of Medicine, Keio University, Tokyo, Japan. Endoscopic transpapillary gallbladder drainage is an effective treatment for acute cholecystitis in patients who cannot undergo surgery because of adverse events or bleeding tendencies. This video describes the use of a new …
Post written by Sanjay Palat, MD, from Internal Medicine, Washington University in St. Louis, St. Louis, Missouri, USA. This case involves a 65-year-old man with a Zenker diverticulum that recurred after 2 unsuccessful surgeries, transoral staple myotomy and revisional transcervical cricopharyngeal myotomy. He noted the recurrence of dysphagia, regurgitation, and weight loss beginning 1 month after his second …
Continue reading Endoscopic management of recurrent Zenker diverticula after failed surgical repairs
Post written by Haruka Okada, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Keio University School of Medicine, Tokyo, Japan. We reported a case in which simultaneous bile duct injury with massive bile leakage and duodenal retroperitoneal perforation during endoscopic submucosal dissection (ESD) for a large periampullary adenoma were successfully managed by …
Post written by Erica Park, MD, from the Division of Gastroenterology, Hepatology, and Nutrition, Ohio State University Wexner Medical Center, Columbus, Ohio, USA. We describe a case of biliary obstruction from a walled-off pancreatic necrosis, for which the patient underwent EUS-guided cystduodenostomy for biliary decompression. The patient’s liver function tests results subsequently improved, which we initially …
Continue reading Diagnosis and treatment of a biliary fistula to walled-off pancreatic necrosis
Post written by Chung-Ying Lee, MD, from the Division of Gastroenterology and Hepatology, Department of Internal Medicine, Shuang Ho Hospital, Taipei Medical University, New Taipei City, Taiwan. We present a video showcasing a novel double endoscope—assisted snare traction method designed to facilitate safe and efficient endoscopic full-thickness resection (EFTR) for a 30-mm exophytic gastric subepithelial lesion …
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