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Joined February 2021
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EndoCollab™ | GI Endoscopy Community retweeted
Barrett's with varices.
50-year-old patient sent for Barrett's esophagus and esophageal varices.
Band ligation of the Barrett's segment obliterates the varices and eradicates the Barrett's mucosa.
Case by Hiral Patel, MD and Klaus Mönkemüller, MD, PhD.
How to Biopsy an Inlet Patch
Inlet patches:
- Common Symptoms
- Therapy
- Esophageal adenocarcinoma transformation
Biopsy process: how to guide the endoscope towards the target area
JNET Classification, Types 1, 2A, 2B and 3.
Adapted from Sano Y, Tanaka S, Kudo SE, et al: Dig Endosc 2016;28:526-33 / Iwatate M, Sano Y, Tanaka S, et al: Dig Endosc 2018;30:642-651 / Sano Y, Hirata D, Saito Y. Dig Endosc 2018;30:543-545.
See, re-form, resect.
See: find it again easily (natural marking).
Re-form: the new shape allows better ensnarement.
Resect: one-piece resection, no slipping away.
From Klaus Mönkemüller's Complex Colon Polyps lecture, Panama.
Klaus teaches this at 45:10 in his new 66-minute atlas, The Complex Colon Polyp: endocollab.com/blogs/full-co…
EndoCollab™ | GI Endoscopy Community retweeted
Cirrhosis, hematemesis and melena for one day. EGD shows this varix.
Which sign is it?
A) Red spots
B) Red wale sign
C) Nipple sign
D) Active bleeding
The case, and why the authors banded quickly, by Rami Musallam, MD and Klaus Mönkemüller, MD, PhD:
Abdominal pain, jaundice and melena the day after a liver biopsy? Think hemobilia.
Only 22% of patients show the full triad. It is often missed because the papilla is not closely inspected on EGD.
Tip: use a distal transparent cap or a side-viewing duodenoscope.
From Chapter 30 of The EndoCollab Guide for GI Bleeding: Abdominal Pain, Jaundice and Melena: Think of Hemobilia. A 224-page atlas of real cases by Klaus Mönkemüller and colleagues. Get it on Amazon: amazon.com/dp/B0FFQ5FYLR
Dynamic injection for a submucosal cushion has two parts.
The nurse pulses the syringe.
You move the needle, the wheels, and the shaft, so the blue mix spreads under the whole polyp.
From Klaus Mönkemüller's new 66-minute atlas of the complex colon polyp.
The full atlas, first 13 minutes free: endocollab.com/blogs/full-co…
EndoCollab™ | GI Endoscopy Community retweeted
The snare keeps slipping off a flat lesion.
Pre-cutting EMR (hybrid ESD-EMR) in 3 steps:
1. Inject a submucosal cushion
2. Incise around the lesion with the snare tip (usually 1-2 mm exposure)
3. Snare in the groove and resect
Full technique by Klaus Mönkemüller, MD, PhD:
How a cholangiogram corresponds to liver segments.
Numbers indicate drained hepatic segments.
Adapted from Pauli et al. Arch Surg 2012 (Diagram), and Abdominal Key (cholangiogram).
EndoCollab Quiz
This lesion was located in the upper esophagus, just distal to the upper esophageal sphincter, at about 17 cm from the incisors.
What's your diagnosis?
Reply below with your answer.
Closure of complex gastro-colo-cutaneous fistula with two scopes
- Case
- Procedures
- Wire through second oostomy-fistula
- Localization of the orifice of the fistula
- Closed with Clips TTS
- Fistula closed with 12/6 OTSC
Patient with intermittent abdominal pain.
Colonoscopy showed this.
What is the diagnosis?
A. Gastrointestinal stromal tumor (GIST)
B. Neuroendocrine tumor (carcinoid)
C. Inverted diverticulum
D. Large lipoma causing intermittent obstruction
Comment your letter first.
Then check the answer in the first comment.
