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. …
Tag: VideoGIE
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 …
Continue reading Primary leiomyosarcoma of the pancreas with metastasis to the spleen
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 …
Continue reading Long per-rectal endoscopic myotomy for a case of Hirchsprung’s disease
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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Precut papillotomy on a minor papilla followed by balloon papilloplasty to provide a complete pancreatic-duct drainage in tropical pancreatitis with reverse pancreas divisum
Post written by Rungsun Rerknimitr, MD, FRCP (London), FASGE, from Chulalongkorn University, Bangkok, Thailand. Our case is about a 10-year-old girl with known tropical chronic pancreatitis with mutation at the transition c.206C>T in exon 4 of the SPINK1 gene who underwent pancreatic sphincterotomy via major papilla with pancreatic stone extraction 6 months prior. The patient presented with a new episode of epigastric pain and elevation …
Transjejunal ERCP, EUS-guided gallbladder drainage, and cholecystoscopy with direct electrohydraulic lithotripsy with large gallstone removal in Roux-en-Y anatomy
Post written by Arjun Chatterjee, MD, from the Department of Internal Medicine, Cleveland Clinic Foundation, Cleveland, Ohio, USA. A 61-year-old man presented with intermittent right-upper-quadrant pain, nausea, and vomiting. A CT scan of his abdomen revealed choledocholithiasis and large cholelithiasis. His medical and surgical history included severe obesity, Roux-en-Y gastric bypass, bowel perforation with extensive resection, …
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