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Endoscopic Stent-in-Stent Placement for the Palliation of Malignant Duodenal Obstruction

Jonathan Buscaglia, MD, Stony Brook University Medical Center
Parantap Gupta, MD, Stony Brook University Medical Center

A 56 year old man with malignant duodenal obstruction presents with recurrent nausea and vomiting. The endoscope is not able to be passed through the existing duodenal stent. Both the duodenal stent and the previously placed biliary stent can be seen. A standard biliary extraction balloon is passed through the narrowed lumen of the previously place [...]

Clip-aided biliary cannulation

Shyam Menon, MRCP, University Hospital Aintree
Richard Sturgess, MD, University Hospital Aintree

An 81-year old male presented to his local hospital with multiple episodes of biliary colic and two episodes of cholangitis. Cross-sectional imaging revealed a 20mm common bile duct stone with dilated extra and intra-hepatic bile ducts. Attempted ERCP failed twice due to the presence of a large duodenal diverticulum. At ERCP, we found a large per [...]

Pancreatic Rests

Andrew J. Bain, MD, University of California San Diego
Suresh Pola, MD, University of California San Diego, Veterans Affairs San Diego Medical Center
Thomas Savides, MD, University of California San Diego

A 54 year old female underwent upper endoscopy at an outside facility for evaluation of dyspepsia showing a subepithelial gastric mass. Mucosal biopsies were non-diagnostic. The patient was referred to our center for endoscopic ultrasound and further tissue sampling. Upper endoscopy showed a 1 cm subepithelial mass in the gastric antrum locate [...]

Biliary IPMN (Intraductal Papillary Mucinous Neoplasm) Diagnosed with Cholangioscopy

Raymond Tang, MD, University of California San Diego
Thomas Savides, MD, University of California San Diego

A 62 year-old man was referred for recurrent obstructive jaundice. Cross-sectional imaging revealed dilated biliary system without obvious obstructing lesion. ERCP at an outside facility demonstrated filling defects in a markedly dilated common bile duct. Bile duct balloon sweeps removed large amount of gelatinous and purulent material but no sto [...]

Diagnosis of Acute Appendicitis with granulomatous disease during colonoscopy

Truptesh H. Kothari, MD, Lenox Hill Hospital
David H. Robbins, MD, Lenox Hill Hospital

Patient is a 27 year old female presents to endoscopy suite for colonoscopy for evaluation of rectal bleeding. Patient denies abdominal pain, fever, chills, nausea, vomiting, bowel – bladder complaints.Patient denies history of surgery and family history of GI cancers or polyps. On physical examination, found to be normal with normal vital s [...]

Metastatic Somatostatinoma

Prashant Kedia, MD, Mount Sinai Medical Center
Ron Lee, MD, Mount Sinai Medical Center
Kalpesh Patel, MD, Mount Sinai Medical Center
Michelle Kim, MD, Mount Sinai Medical Center

A 41 year old surgeon presented with several months of epigastric pain. A CT scan was performed which revealed multiple masses in the liver, the largest of which measured approximately 7.4 cm in diameter. Some of these lesions demonstrated high peripheral density suggestive of calcification; no obvious pancreatic mass was noted. A CT guided biop [...]

Intraductal Papillary Mucinous Neoplasm (IPMN) with Malignant Biliary Invasion

Patrick Yachimski, MD, Vanderbilt University Medical Center

The patient is an 84 year old male who had previously been diagnosed with a main duct IPMN involving the pancreatic head. The patient had opted for expectant management in lieu of surgical resection, and had been relatively asymptomatic for 2 years, until presenting with jaundice, cholangitis, and gram negative sepsis. An abdominal CT demonst [...]

Colon Cancer Prevention: EMR of Flat Lesion – SSA

Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano, MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center

Colon cancer prevention series: we would like to share with you endoscopic mucosal resection of a flat lesion in the cecum. Here is a 62 year old man who was recently diagnosed with prostrate cancer. He was referred to us for colonoscopy. He had two large sessile serrated adenomas removed earlier. He came in for removal of additional lesions. In th [...]

Colon Cancer Prevention: Flat Lesion and Endoscopic Mucosal Resection

Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano , MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center

In this colon cancer prevention series, we would like to show you a flat lesion and its removal using endoscopic mucosal resection technique. A 70-year-old man with prior colon cancer resection and negative colonoscopies on several occasions came in for surveillance examination. As you can see here, there is a flat lesion evidenced by a red patch a [...]

How to record and edit endoscopy videos: Equipment set-up

Evan S. Dellon, MD, MPH, University of North Carolina

Overview and objectives This video will review the equipment and set-up needed to record high-quality endoscopic video. At the end of this presentation, you will know the specific equipment needed, how to set-up this equipment for use during a procedure, and how to capture video footage. A schematic of the set-up is shown here. The vid [...]