Cold Snare Polypectomy: Why Forceps and Hot Biopsy Fail
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Prevent Post-Polypectomy Bleeding Before You Cut
Two Techniques That Prevent Bleeding Before You Cut You are about to resect a large flat polyp in the right colon. The patient takes apixaban. The resection itself is straightforward, but what happens after you cut determines whether the patient comes back over the weekend with delayed bleeding. Two decisions made before the snare closes…...
Extreme Endoscopy: The Double-Scope Rescue for Esophageal Perforation
Extreme Endoscopy: The Double-Scope Rescue A patient arrives after esophageal stent placement gone wrong. The stent has migrated across the esophagogastric junction into the pleura. There is a large perforation, sepsis, open surgery, and now a complete anastomotic dehiscence. Upper endoscopy confirms the guidewire is entering the abdominal cavity. Standard wire placement is not possible…....
Using a Distal Cap to Remove Meat Impaction
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Managing Heyde Syndrome: From Aortic Valves to Endoscopic Intervention
Heyde syndrome represents one of the most fascinating intersections between cardiology and gastroenterology, where aortic stenosis leads to gastrointestinal bleeding through acquired von Willebrand disease. Understanding the full spectrum of management options is crucial for optimizing patient outcomes in this complex condition. The Expanding Spectrum of Heyde Syndrome What we’ve learned over the years…...
Mastering Argon Plasma Coagulation: Four Essential Techniques for Better Outcomes
Argon plasma coagulation (APC) ranks among the most frequently performed therapeutic interventions in gastrointestinal endoscopy. While APC serves multiple purposes beyond hemostasis, mastering the nuances of bleeding control: whether for prophylaxis or active treatment: remains fundamental to our practice. Today, I’ll share four refined techniques that can significantly improve your outcomes when treating angiodysplasias, GAVE,…...
Hemostatic Powders: A Modern Tool for Gastrointestinal Bleeding
Hemostatic powders represent one of the most interesting developments in endoscopic bleeding management over the past decade. While traditional mechanical and thermal methods remain our mainstays, these powder-based agents offer unique advantages in challenging bleeding scenarios where conventional approaches may fall short. The Science Behind Hemostatic Powders The mechanism of action for hemostatic powders is…...