Pneumatosis Coli: Characteristics, Diagnosis, and Etiologies
An elderly patient presented with abdominal pain, diarrhea, and fever. A colonoscopy found pneumastosis coli in sigmoid colon polypoid lesions ranging from 10 to 30mm in size. This article describes the diagnosis, characteristics, and etiologies of pneumatosis coli. Key Points: Conclusion:Pneumatosis coli is a condition with multiple potential etiologies that can present in children and […]
(DIE) – Dabigatran-Induced Exfoliative Esophagitis
Non-vitamin K anticoagulants (NOAC), also known as direct oral anticoagulants (DOAC) are now commonly used for a variety of conditions requiring chronic anticoagulation. The dabigatran pellets are covered with a tartaric acid core. This strong acid may result in squamous epithelial damage with ensuing exfoliative esophagitis. Elderly patients are more prone to suffer esophageal damage […]
Tattooing – Tips and Tricks for the Best India Ink Tattoo
India ink tattooing is a crucial technique in endoscopy, allowing surgeons to locate and resect lesions precisely, enabling minimally invasive approaches. Proper Injection Technique Avoid transmucosal or full-thickness needle insertion to prevent intraperitoneal injection and potential complications. Create a submucosal cushion by injecting saline first, followed by the ink, ensuring the ink remains contained within […]
Gastric Hyperplastic Polyps
Question: A routine EGD for GERD, found to have one gastric polyp 8mm – turned out to be a hyperplastic polyp in at 45M? No H. pylori, no atrophy. Follow up? Short answer: No surveillance is necessary in this patient, especially because the patient is NOT infected with H. pylori and there was no gastric […]
Does the White Deposit (Chicken Skin Sign) Around the Base of the Polyps Have Any Prognostic Value?
“Chicken skin” mucosa (or “goose skin” in German-speaking countries, or “fish skin” in the Mediterranean and some Far East countries) was first described in Western countries in 1998 by Shatz et al. (Am J Gastroenterol). The authors found that CSM was associated frequently with adenomatous polyps and adenocarcinoma. Histologically, CSM is caused by an accumulation […]
Is a Fully Covered Self-Expanding Metal Stent an Option for Recalcitrant Duodenal Stenosis?
I have only used fully covered self-expanding metal stents for palliative situations such as malignant gastric outlet obstruction or duodenal perforation (by instruments or due to lymphoma). There are case reports of using fc-SEMS for benign conditions. Your case is very challenging as the patient likely has recalcitrant duodenal obstruction due to medications (NSAIDS). I […]
Do You Use CO2 and Water Immersion in Diagnostic Colonoscopies on a Daily Basis?
Yes. And Yes.
Know Your Liver Segments
It’s very important that you know your liver segments. This chart shows you a nice ways to memorize. It’s important that we correlate to where the segments are to the cholangiogram. As we can see here, the left liver lobes 2, 3, and 4 are drained by the left hepatic. And the right hepatic consists […]
How to Become an Expert in ERCP
Watch the Expert Rendezvous PTCD-ERCP triple-wire-technique followed by 5 plastic stents of different diameters Watch Videos, Visit Congresses, Become a Member of a Community or Endoscopic Society ERCP Models In Sum:
Long Term POEM Success
What do you think of the Long Term POEM success? There is little long-term data. So far, we know that a significant amount of patients develop severe reflux esophagitis and stricturing esophageal disease. I still think that POEM is a good alternative for patients who are poor surgical candidates, but am still not 100% convinced […]