Post written by Sooraj Tejaswi, MD, MSPH, FASGE, from the University of California Davis School of Medicine, Sacramento, California, and Texas Digestive Disease Consultants, The Woodlands, Texas, USA. A 63-year-old woman had incidentally noted abnormal liver test results with transaminitis (aspartate aminotransferase 104 U/L, alanine transaminase 233 U/L), elevated alkaline phosphatase (290 U/L), and mild hyperbilirubinemia (total …
Tag: VideoGIE
Endoscopic lithotripsy of a gallstone impacted in lumen-apposing metal stent positioned for cholecysto-gastrostomy
Post written by Mauro Manno, MD, from the Gastroenterology and Digestive Endoscopy Unit, Azienda USL Modena, Carpi, Italy. EUS-guided gallbladder drainage with a lumen-apposing metal stent (LAMS) is a viable treatment option for acute cholecystitis and an alternative to cholecystectomy in patients at high risk for surgery. However, recurrent acute cholecystitis with stone impaction in the LAMS can …
Double-balloon enteroscopy with EUS-guided rendezvous for failed cannulation in patients with history of Roux-en-Y gastric bypass
Post written by Kambiz S. Kadkhodayan, MD, from the Center for Interventional Endoscopy, AdventHealth, Orlando, Florida, USA. We describe 2 patients with Roux-en-Y gastric bypass (RYGB) who underwent double-balloon enteroscopy—assisted ERCP (DBE-ERCP) for the management of pancreatolithiasis and choledocholithiasis. After reaching the ampulla, deep cannulation of the bile duct could not be achieved using the enteroscope. …
Circumferential endoscopic submucosal dissection of distal rectal polyp in a patient with portal hypertension complicated by bowel obstruction
Post written by Siddharth B. Javia, MD, from Confluence Health, Wenatchee, Washington, USA. Our video demonstrates a technique for circumferential endoscopic submucosal dissection (ESD) without using any traction accessories. This was performed in a patient who had significant scarring from Crohn’s colitis and portal hypertension with large blood vessels in the submucosa, which made ESD challenging. …
Primary leiomyosarcoma of the pancreas with metastasis to the spleen
Post written by Philippe Willems, MD, from the Center for Advanced Endoscopy, Research & Education, Orlando Health Digestive Health Institute, Orlando, Florida, USA. A 46-year-old woman was evaluated in the endoscopy unit for intermittent epigastric pain. On EUS examination, a large, hypoechoic, and irregular mass was found in the pancreas, and a similar 6-cm lesion was …
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Long per-rectal endoscopic myotomy for a case of Hirchsprung’s disease
Post written by Akshay Kulkarni, DM, from Midas Multi-Specialty Hospital, Nagpur, India. This video case shows the procedure of per-rectal endoscopic myotomy (PREM) for a case of Hirchsprung’s disease. It was a particularly difficult case requiring a long (25 cm) myotomy, and a delayed perforation complicated recovery. However, it was successfully managed endoscopically, and the patient …
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Deploying automated machine learning for computer vision projects: a brief introduction for endoscopists
Post written by Neal Mahajan, ScB, from the Division of Gastroenterology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, and Indiana University School of Medicine, Indianapolis, Indiana, USA. Our team has worked for several years on the use of machine learning (ML) in endoscopy and helped validate its additive effect in the endoscopy suite. We have noticed …
Full-thickness resection closure using reopenable-clip over-the-line method inside a submucosal pocket
Post written by Tatsuma Nomura, MD, from Mie Prefectural Shima Hospital, Shima, Mie, Japan. We recently developed a new procedure known as full-thickness resection closure using a reopenable-clip over-the-line method inside a submucosal pocket (ROLM-SP) procedure. During this procedure, the first mucosal incision was made at 20 mm from the center, and a calibrated, small-caliber tip, …
EUS-guided choledochoantrostomy as an alternative for biliary decompression in malignant distal biliary obstruction with duodenal invasion
Post written by Ahmed Altonbary, MD, FRCP, from Mansoura Specialized Medical Hospital, Mansoura University, Mansoura, Egypt. We describe a case of unresectable pancreatic cancer with extrahepatic biliary obstruction and duodenal invasion that was successfully treated with a variant of EUS-guided biliary drainage by performing EUS-guided choledochoantrostomy (EUS-CAS). EUS-guided choledochoduodenostomy (EUS-CDS) is commonly performed for biliary decompression …
Ex vivo nonbiomaterial gel-based model for endoscopic training
Post written by Ameya Deshmukh, DO, from the Department of Internal Medicine, Saint Louis University – SOM, St. Louis, Missouri, USA. EndoGel (Sunnarow Limited, Tokyo, Japan) is an ex vivo gel-based simulator that is designed to behave similarly to intestinal mucosa. It uses polyvinyl alcohol hydrogel materials, enabling this gel-based model to accurately mimic en vivo …
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