MedWorm.com provides a medical RSS filtering service. Over 6000 RSS medical sources are combined and output via different filters. This feed contains the latest items from the 'The Digital Atlas of Video Education - Gastroenterology' source. Wed, 08 Feb 2012 16:28:30 +0100 http://www.medworm.com/index.php?rid=5525904&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FrEHyJO4hb1w%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5525904 Wed, 21 Dec 2011 10:56:13 +0100 5525904 http://www.medworm.com/index.php?rid=5505921&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FSMeEKDZZCis%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5505921 Thu, 15 Dec 2011 11:12:30 +0100 5505921 http://www.medworm.com/index.php?rid=5495391&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FQd52z1fEep0%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5495391 Mon, 12 Dec 2011 11:12:13 +0100 5495391 http://www.medworm.com/index.php?rid=5477263&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2F1oKNTePPiPg%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5477263 Tue, 06 Dec 2011 09:12:25 +0100 5477263 http://www.medworm.com/index.php?rid=5477264&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FQ509H-N499E%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5477264 Mon, 05 Dec 2011 09:12:07 +0100 5477264 http://www.medworm.com/index.php?rid=5238843&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FVZAJ370ZbJI%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5238843 Wed, 21 Sep 2011 10:00:31 +0100 5238843 http://www.medworm.com/index.php?rid=5238844&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FOoIbxy6Zg14%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=5238844 Tue, 20 Sep 2011 13:07:28 +0100 5238844 http://www.medworm.com/index.php?rid=4938518&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FI3Pf0wxpGRk%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4938518 Wed, 15 Jun 2011 12:06:12 +0100 4938518 http://www.medworm.com/index.php?rid=4914542&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FGDhWNQ8klzs%2F Gottumukkala S. Raju, MD, MD Anderson Cancer Center Liben Mahometano, 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4914542 Fri, 10 Jun 2011 09:40:26 +0100 4914542 http://www.medworm.com/index.php?rid=4914543&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FKgMDGptxGY0%2F 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 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4914543 Thu, 09 Jun 2011 12:06:20 +0100 4914543 http://www.medworm.com/index.php?rid=4904757&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FR5KiZD1E96c%2F W. Scott Butsch, MD, Massachusetts General Hospital Dr W. Scott Butsch, physician in the MGH Weight Center, presented at the clinical fellows' conference at the MGH GI Unit. The topic of was management of complications following weight loss surgery. The presentation was recorded 31 May 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4904757 Mon, 06 Jun 2011 12:06:30 +0100 4904757 http://www.medworm.com/index.php?rid=4886224&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2Fei4yjixm6ZU%2F Charles Chaya, MD, Kaiser Permanente Riverside Medical Center Albert Ko, MD, Kaiser Permanente Riverside Medical Center Mark Taira, MD, Kaiser Permanente Riverside Medical Center Jane Tongson-Ignacio, MD, Southern California Permanente Medical Group Regional Laboratory Brian S. Lim, MD, Kaiser Permanente Riverside Medical Center 60 year old female presented with episodes of hypoglycemia with glucose in the range of 55 to 63. Her symptoms included night sweats and confusion during the day time for which patient would eat peanut butter with improvement. Symptoms were worse with exercise. Patient was found to have high insulin level of 20 (normal 3 - 11 mU/L). C-peptide [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4886224 Thu, 02 Jun 2011 12:06:13 +0100 4886224 http://www.medworm.com/index.php?rid=4886225&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FBG8QagUWuLE%2F Lawrence S. Friedman, M.D., Newton-Wellesley Hospital Dr Lawrence Friedman, Chair of the Department of Medicine at Newton-Wellesley Hospital and Assistant Chief of Medicine at Massachusetts General Hospital presented grand rounds at the MGH GI Unit. The topic was autoimmune hepatitis. The presentation was recorded 31 May 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4886225 Wed, 01 Jun 2011 09:00:29 +0100 4886225 http://www.medworm.com/index.php?rid=4865015&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FfS2qqnYfXXk%2F Shyam Menon, MRCP, University Hospital Aintree Richard Sturgess, MD, University Hospital Aintree A 91-year old woman was admitted with painless jaundice, weight loss and Cholestatic symptoms. Imaging revealed dilated intra and extra-hepatic bile ducts down to the level of the ampulla. We were unable to initially obtain selective deep cannulation of the bile duct using a sphincterotome and wire in a standard technique as the ampulla was very fl [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4865015 Thu, 26 May 2011 13:05:35 +0100 4865015 http://www.medworm.com/index.php?rid=4865016&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FPMA_aPgRZU0%2F Shyam Menon, MRCP, University Hospital Aintree Monica Terlizzo, MD, University Hospital Aintree Richard Sturgess, MD, University Hospital Aintree A 68-year old man was admitted with weight loss, deep jaundice and Cholestatic liver function tests (LFTs). Cross-sectional imaging revealed dilatation of the intrahepatic ducts. Close inspection revealed a sharp cut-off at the level of the hilum suggestive of a hilar infiltrative process. Moreover, the intrahepatic ducts were not significantly dil [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4865016 Thu, 26 May 2011 12:57:00 +0100 4865016 http://www.medworm.com/index.php?rid=4806778&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FwM7tW1mByEM%2F Vincent W. Yang, MD, PhD, Emory University School of Medicine Dr Vincent Yang, Director of the Division of Digestive Diseases at Emory University School of Medicine, presented clinical grand rounds at the MGH GI Unit. The topic was screening for Lynch Syndrome (HNPCC). The presentation was recorded 19 April 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806778 Fri, 06 May 2011 08:05:13 +0100 4806778 http://www.medworm.com/index.php?rid=4806779&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FAr_e4Uesu_U%2F Gottumukkala S. Raju, MD, MD Anderson Cancer Center Muslim Atiq, MD, MD Anderson Cancer Center Jeffrey H. Lee, MD, MD Anderson Cancer Center Staging of gastric cancer. A 73 year old man underwent EGD for gastroesophageal reflux disease. It revealed a 3 cm antral mass; biopsies were positive for cancer. He was referred to our center for tumor staging. It consisted of a CT scan to rule out metastasis and an EUS for locoregional staging. Let us look at the CT scan first. As you can see her [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806779 Wed, 27 Apr 2011 07:04:28 +0100 4806779 http://www.medworm.com/index.php?rid=4806780&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FuI-Pu4rkVRo%2F Sophia Jagroop, MD, Stony Brook University Medical Center Dr Sophia Jagroop, GI Fellow at Stony Brook University Medical Center, reviewed the recent article from the journal Gastroenterology titled "Budesonide Is Effective in Adolescent and Adult Patients With Active Eosinophilic Esophagitis". The presentation was recorded in April 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806780 Tue, 26 Apr 2011 07:04:08 +0100 4806780 http://www.medworm.com/index.php?rid=4806781&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FE5JraOWH18g%2F Susana Gonzalez, MD, Columbia University Medical Center Dr Susana Gonzalez, Interventional Endoscopy Fellow at Columbia University Medical Center, delivered clinical grand rounds at the Massachusetts General Hospital GI unit. The topic was improving diagnosis of indeterminate biliary strictures. The presentation was recorded in March 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806781 Mon, 25 Apr 2011 08:04:04 +0100 4806781 http://www.medworm.com/index.php?rid=4806782&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FatTg_FXS-58%2F Dr. Quan Wai Leong, Tan Tock Seng Hospital, Singapore Endoscopic ampullectomy has been considered a high risk procedure associated with a higher complication rate of bleeding, perforation and pancreatitis compared to conventional ERCP. Much effort has been spent on using different technique, equipment and different power settings of the electrosurgical unit in an attempt to minimize complications. T [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806782 Thu, 21 Apr 2011 07:04:49 +0100 4806782 http://www.medworm.com/index.php?rid=4806783&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FIL5L7ehtTV4%2F Gottumukkala S. Raju, M.D., MD Anderson Cancer Center Sathya Jaganmohan, MD, University of Texas Medical Branch Jeffrey H. Lee, MD, MD Anderson Cancer Center In this EUS Learning Series, the next step is Linitis Plastica. A 55 year old man is referred for evaluation of gastric cancer diagnosed at an outside facility. He had undergone EGD, EUS and probe sonography; a diagnosis of Linitis Plastica was made. We would like to show stomach anatomy in health and in Linitis Plastica to appreciate the features. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806783 Thu, 21 Apr 2011 07:04:00 +0100 4806783 http://www.medworm.com/index.php?rid=4806784&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FHr9uZEi4-io%2F Antonio Mendoza Ladd, MD, Lenox Hill Hospital David H. Robbins, MD, Lenox Hill Hospital A 35 Year old Caucasian female was referred for evaluation of heartburn refractory to PPI. At upper endoscopy a 1X2 cm gastric diverticulum was incidentally found in the fundus of the stomach. Closer examination of this diverticulum revealed no mass or perforation of its walls. It was covered with normal appearing mucosa and did not show any evid [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806784 Wed, 20 Apr 2011 11:04:42 +0100 4806784 http://www.medworm.com/index.php?rid=4938519&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FeMbIkkDXk0c%2F Gottumukkala S. Raju, M.D., MD Anderson Cancer Center Liben Mahometano, Asif Rashid, MD, PhD, MD Anderson Cancer Center Patrick Lynch, MD, MD Anderson Cancer Center In this series on colon cancer prevention, we would like to show some subtle lesions in colon. Here you see a flat lesion identified by the vessel cut-off sign. After injection of submucosal saline, you could identify the lesion a little bit better. Notice the changes in the surface mucosal pit pattern compared to the normal surrounding area &#8211 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4938519 Wed, 20 Apr 2011 11:04:36 +0100 4938519 http://www.medworm.com/index.php?rid=4806785&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FeMbIkkDXk0c%2F Gottumukkala S. Raju, M.D., MD Anderson Cancer Center Liben Mahometano, Asif Rashid, MD, PhD, MD Anderson Cancer Center Patrick Lynch, MD, MD Anderson Cancer Center In this series on colon cancer prevention, we would like to show some subtle lesions in colon. Here you see a flat lesion identified by the vessel cut-off sign. After injection of submucosal saline, you could identify the lesion a little bit better. Notice the changes in the surface mucosal pit pattern compared to the normal surrounding area &#8211 [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806785 Wed, 20 Apr 2011 11:04:36 +0100 4806785 http://www.medworm.com/index.php?rid=4806786&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FJ3u_u-Q2__Q%2F Greg Fricchione, MD, Massachusetts General Hospital Dr Greg Fricchione, Director of the Division of Psychiatry and Medicine at Massachusetts General Hospital, delivered GI Grand Rounds on the topic of psychosomatic medicine. The presentation was recorded on 08 March 2011. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806786 Tue, 19 Apr 2011 11:04:10 +0100 4806786 http://www.medworm.com/index.php?rid=4806787&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FjLLmyAjdVmE%2F Katherine Freeman, MD, Stony Brook University Medical Center Dr Katherine Freeman, G.I. Fellow at Stony Brook University, reviews the recent article from JAMA titled "Low-dose Aspirin Use and Performance of Immunochemical Fecal Occult Blood Tests". [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806787 Tue, 19 Apr 2011 11:04:07 +0100 4806787 http://www.medworm.com/index.php?rid=4806788&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FGAfI1wyJjQU%2F David Arner, MD, University of Virginia Bryan Sauer, MD, University of Virginia Vanessa Shami, MD, University of Virginia A 41 year-old female presented to her primary care physician with back pain. Abdominal CT revealed a heterogeneous cystic mass in the body of the pancreas measuring 5.8 x 5.3 x 4.9 cm. Further evaluation with endoscopic ultrasound (EUS) revealed a 5cm multiseptated grossly solid cystic lesion consistent with a pseudopapillary neoplasm. After color [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806788 Mon, 21 Feb 2011 07:02:55 +0100 4806788 http://www.medworm.com/index.php?rid=4806789&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2F0Oemi3kvD9M%2F Shahzad Iqbal, MD, Columbia University Medical Center Peter D. Stevens, MD, Columbia University Medical Center This is a 59 years old patient who was recently diagnosed with pancreatic adenocarcinoma metastatic to the liver. MRCP showed bilateral intrahepatic biliary dilation with abrupt central termination (these findings were compatible with Bismuth IV tumor). He underwent PTCA with right liver external-internal drain placement, and ERCP with left liver p [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806789 Mon, 21 Feb 2011 07:02:50 +0100 4806789 http://www.medworm.com/index.php?rid=4806790&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2F45RPB4ZQ7fQ%2F We present the case of a 66 y o gentleman who had chronic pancreatitis and abdominal pain who underwent a pancreatic head resection and a Peustow procedure. The post-operative course was complicated by the development of an intra-abdominal hematoma. The hematoma is shown by the arrow here on the CT scan. An angiogram demonstrated an aneurysm of th [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806790 Sat, 29 Jan 2011 16:01:28 +0100 4806790 http://www.medworm.com/index.php?rid=4806791&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2F8OvyLJOcLRI%2F We present a case of 31years old female who was evaluated for intermittent episodes of nausea, non-bilious vomiting & upper abdominal discomfort for more than one year. Her past medical history was significant for resolved Parotid and Thyroid cancers. Remaining history and review of the systems were unremarkable. Her physical ex [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806791 Fri, 28 Jan 2011 09:01:08 +0100 4806791 http://www.medworm.com/index.php?rid=4806792&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FesVlg6KOqaE%2F We present a case of a 44 y old woman with primary biliary and alcoholic cirrhosis who presented with RUQ pain and encephalopathy. Further evaluation revealed acute cholecystitis with VRE and Candida bacteremia. She was not a candidate for laparoscopic cholecystectomy or radiologic cholecystostomy tube due to her decompensated cirrhosis, with a M [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806792 Tue, 28 Dec 2010 11:12:34 +0100 4806792 http://www.medworm.com/index.php?rid=4806793&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FFFP6FB109oE%2F Suresh Pola, MD, University of California San Diego, Veterans Affairs San Diego Medical Center A 56 year-old man was referred for colonoscopy after experiencing three months of watery diarrhea and crampy abdominal pain. He denied fevers or chills, hematochezia, recent travel, sick contacts, or recently taking antibiotics. His primary care physician referred him for colonoscopy after he was found to have a leukocytosis of 15,200 with 70% ne [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806793 Thu, 23 Dec 2010 12:12:27 +0100 4806793 http://www.medworm.com/index.php?rid=4806794&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FuWFHSebksi0%2F John C. Deutsch, MD, St. Mary's Duluth Clinic Granular cell tumors (GCT) are relatively uncommon, but can occur through out the length of the gastrointestinal tract, particularly in the esophagus (1). Endoscopically, they appear as firm yellow nodules and can be mistaken for lipomas, carcinoid tumors and gastrointestinal stromal tumors. GCT generally behave in a benign manner, although mal [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806794 Tue, 21 Dec 2010 17:12:15 +0100 4806794 http://www.medworm.com/index.php?rid=4806795&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FqJULH9Hn3cY%2F Christopher C. Thompson, M.D., Brigham and Women's Hospital Dr Christopher Thompson, Director of Developmental Endoscopy at Brigham and Women's Hospital, presented clinical grand rounds at the Massachusetts General Hospital GI Unit. Topics discussed include a review of bariatric basics, current management strategies, and the emerging endoscopic paradigm for bariatric management. The presentation was rec [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806795 Tue, 14 Dec 2010 10:12:45 +0100 4806795 http://www.medworm.com/index.php?rid=4806796&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FU9BsXbCIv9Q%2F Kenneth E. Hung, MD, PhD, Tufts University School of Medicine Dr Kenneth Hung, Assistant Professor of Medicine at Tufts School of Medicine, presented clinical grand rounds at the MGH GI Unit on the topic of developing personalized medical paradigms for colorectal cancer. The presentation was recorded 23 November 2010. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806796 Fri, 10 Dec 2010 08:12:09 +0100 4806796 http://www.medworm.com/index.php?rid=4806797&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Ffeedproxy.google.com%2F%7Er%2FDAVEProject%2F%7E3%2FB31y2hHyXNA%2F Sam S. Yoon, MD, Harvard Medical School, Massachusetts General Hospital Dr Sam Yoon, Assistant Professor of Surgery in the Division of Surgical Oncology at the Massachusetts General Hospital Cancer Center, presented clinical grand rounds at the MGH GI Unit on the topic of gastric cancer surgery and adjuvant therapies. The presentation was recorded 9 November 2010. [...] (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4806797 Wed, 08 Dec 2010 10:12:37 +0100 4806797 http://www.medworm.com/index.php?rid=4231186&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Famoss_cgr_20101102.mov.flv Dr Alan C Moss, Director of Translational Research, Center for Inflammatory Bowel Disease at Beth Israel Deaconess Medical Center, presented clinical grand rounds at the MGI GI Unit on the topic of prophylaxis against recurrence of Crohn's Disease. The presentation was recorded 2 Nov 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4231186 Mon, 06 Dec 2010 15:12:57 +0100 4231186 http://www.medworm.com/index.php?rid=4226741&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fjsaltzman-cgr_20101012.mov.flv Dr. John Saltzman, Director of Endoscopy at Brigham and Women's Hospital, presents clinical grand rounds at the MGH GI Unit on the topic of management of upper gastrointestinal bleeding. The presentation was recorded 2010 October 12. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4226741 Fri, 03 Dec 2010 09:12:52 +0100 4226741 http://www.medworm.com/index.php?rid=4226740&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fkandersson_cgr_20101019.mov.flv Dr Karin Andersson, Instructor in Medicine at Massachusetts General Hospital, presented clinical grand rounds at the MGH GI Unit on the topic of lesser known hepatitis viruses A, D, and E. The presentation was recorded 2010 October 19. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4226740 Fri, 03 Dec 2010 09:12:20 +0100 4226740 http://www.medworm.com/index.php?rid=4226742&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fitskots-EUS-201012us.mpg.flv Conclusion Our patient has been symptom free since the resection and a repeat CT abdomen did not show any evidence of recurrence over a period of 15 months. Surgery is the treatment of choice for the solid pseudopapillary tumor of the pancreas with an excellent prognosis. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4226742 Fri, 03 Dec 2010 08:12:12 +0100 4226742 http://www.medworm.com/index.php?rid=4180271&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.mas.glu.fna.3.mpg.flv A 64 year-old female was evaluated by a local dermatologist for a new onset plaque-like erythematous rash on her lower extremities that extended to her buttocks and back. She tried various topical treatments with no improvement and subsequently underwent punch biopsy of the rash which showed a dermatitis pattern strongly suggestive of a nutritional deficiency or glucagonoma. Further evaluation revealed elevated chromogranin A and serum glucagon and she was referred to our center for further evaluation and treatment. She reported a 40 lb unintentional weight loss, episodes of hyperglycemia, and a ?beefy red tongue? without symptoms suggesting MEN-1 syndrome. Review of previous records demonstrated abdominal CT with a 2.5x3cm lesion in the tail of the pancreas as seen on axial and corona... The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4180271 Thu, 18 Nov 2010 07:11:48 +0100 4180271 http://www.medworm.com/index.php?rid=4156329&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Ffreeman_cjc_20100922.mov.flv Dr Katherine Freeman, GI Fellow at Stony Brook University, reviews the recent article in the journal Gastroenterology and Hepatology titled "Rabeprazole is effective in treating laryngopharyngeal reflux in a randomized placebo-controlled trial". The presentation was recorded 22 October 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4156329 Thu, 11 Nov 2010 10:11:59 +0100 4156329 http://www.medworm.com/index.php?rid=4156328&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FManolo_cjc_20100922.mov.flv Dr Joseph Manlolo, GI Fellow at Stony Brook University, reviews the recent article from the New England Journal of Medicine titled "Telaprevir for Previously Treated Chronic HCV Infection". The presentation was recorded 22 October 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=4156328 Thu, 11 Nov 2010 10:11:25 +0100 4156328 http://www.medworm.com/index.php?rid=3978462&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FPadda-Aslanian_SpleenEusFna1.mpg.flv An 84 year old male with history of melanoma of the scalp diagnosed two years prior, was found to have a splenic lesion on abdominal CT scan. CT scan showed a round, hypoechoic lesion in the spleen as shown by the arrow. Linear EUS examination identified a 2 cm round, hypoechoic, hypovascular and heterogeneous lesion in the spleen as shown by the arrow. Arrow in the image points towards the splenic vessels surrounding this lesion. After confirming the absence of the vessels, 25 G needle was used to perform the FNA. Cytology showed giant tumor cells with enlarged nuclei. This image shows HMB 45 immunostains of the FNA cytology. This image shows S100 immunostain. The immunophenotype was consistent with metastatic melanoma. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3978462 Fri, 17 Sep 2010 09:09:31 +0100 3978462 http://www.medworm.com/index.php?rid=3978463&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Frchung_cgr_20100914.mov.flv Dr Raymond Chung, Director of Hepatology at Massachusetts General Hospital, presented clinical grand rounds at the MGH GI unit on the topic of clinical advances in treatment of Hepatitis C. This presentation was recorded 14 September 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3978463 Fri, 17 Sep 2010 08:09:19 +0100 3978463 http://www.medworm.com/index.php?rid=3974450&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fbhaveshbshah-LASE.mov.flv Our patient is a 31 year-old woman with Peutz-Jeghers Syndrome, a history of GI bleeding and multiple abdominal surgeries who had a video capsule endoscopy for surveillance of her small bowel. At two hours and 13 minutes into her study, video capsule endoscopy revealed a large pedunculated polyp, seen here in the distal small bowel; this was located most likely in the jejunum. Because of the patient's risk factors and the large size of the polyp, jejunal polypectomy was attempted. Attempts to reach the polyp with spiral enteroscopy and lower double balloon enteroscopy were unsuccessful, and the patient was scheduled for a laparoscopic assisted spiral enteroscopy. After insufflation of the abdomen with carbon dioxide, the anterior abdominal wall adhesions which were seen we... The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3974450 Thu, 16 Sep 2010 13:09:59 +0100 3974450 http://www.medworm.com/index.php?rid=3955914&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fjacobson_crg_20100907.mov.flv Dr Brian Jacobson, current Chair of the ASGE Health and Public Policy Committee, delivered Grand Rounds at Massachusetts General Hospital GI Unit on the topic of the recently passed "Patient Protection and Affordable Care Act" health care reform law and the changes which may impact gastroenterologists. The presentation was recorded 7 September 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3955914 Fri, 10 Sep 2010 15:09:46 +0100 3955914 http://www.medworm.com/index.php?rid=3955915&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fpyachimski-CTLA4colitis.mpg.flv A 55 year old male was referred for colonoscopy. His medical history was notable for metastatic melanoma, for which he had recently begun therapy with ipilimumab, a monoclonal antibody directed against cytotoxic T lymphocyte antigen 4. Within several days of initial infusion, he experienced onset of profuse watery diarrhea. Colonoscopy demonstrated diffuse, confluent mucosal edema and erythema, consistent with acute colitis. This sequence of images is from the descending colon. Multiple superficial erosions and fibrinous exudate are evident. While there was no spontaneous active bleeding, the tissue was quite friable, as demonstrated by tissue biopsy acquisition. Histopathology demonstrated an inflammatory infiltrate evident even on low-powered view. The cellular inflammatory infiltrate... The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3955915 Fri, 10 Sep 2010 14:09:30 +0100 3955915 http://www.medworm.com/index.php?rid=3955916&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.d.aef.ooo.ooo.ooo.1ro.go1003sp.mpg.flv A 24 year old male patient with hematemesis was evaluated in the emergency room. One year previously he had sustained an abdominal gunshot complicated with an aortic infra-renal pseudo-aneurysm that required placement of an aortic Dacron knitted graft. The physical examination upon admission was unremarkable. An upper endoscopy was performed, but the source of bleeding was not identified. Computed tomography scan with oral contrast reported the graft in close contact with the lumen of the third portion of the duodenum. We decided to use a colonoscope to achieve complete visualization of the duodenal lumen and found an area of transmural ulceration in the third portion of the duodenum, in which the Dacron stent could be visualized through the wall observing only a small amount of blood oozi... The Digital Atlas of Video Education - Gastroenterology video http://www.medworm.com/rss/comments.php?id=3955916 Fri, 10 Sep 2010 14:09:12 +0100 3955916 http://www.medworm.com/index.php?rid=3874096&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fleffer_cgr_20100622.mov.flv Dr Daniel Leffler, Director of Clinical Research of the The Celiac Center at Beth Israel Deaconess Medical Center, presented clinical grand rounds at the MGH GI Unit on the topic of celiac disease. The presentation was recorded June 22, 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3874096 Tue, 17 Aug 2010 14:08:41 +0100 3874096 http://www.medworm.com/index.php?rid=3874097&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fgupta_cjc_20100611.mov.flv Dr. Parantap Gupta, GI Fellow at Stony Brook University Medical Center, reviewed the article from April 2010 in the New England Journal of Medicine titled "Infliximab, Azathioprine, or Combination Therapy for Crohn's Disease". (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3874097 Tue, 17 Aug 2010 14:08:24 +0100 3874097 http://www.medworm.com/index.php?rid=3874098&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fgupta_cjc_20100610.mov.flv Dr Parantap Gupta, GI Fellow at Stony Brook Medical Center, reviews the March 2010 article from the New England Journal of Medicine titled "Rifaximin treatment in hepatic encephalopathy" (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3874098 Tue, 17 Aug 2010 14:08:03 +0100 3874098 http://www.medworm.com/index.php?rid=3856319&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fmparaoan_lap-resect-col-les.mpg.flv A 79 years old male patient was referred to our unit for laparoscopic resection of a small malignant right-sided colonic lesion identified during a previous colonoscopy. A repeat full colonoscopy with intubation of the terminal ileum was performed. During withdrawal phase a 2.5 centimetres non-polypoid lesion was identified at the level of the hepatic flexure. Under magnification the lesion has an obvious malignant appearance and therefore is not resectable endoscopically. A smaller benign subpedunculated polyp was identified distally. To facilitate a laparoscopic resection with safe surgical margins tattooing was performed using tri-quadrant non-spilling technique. The endoscope is withdrawn and the tattoo site is selected 4 to 5 cm distally with the lesion still in view. The injectio... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3856319 Wed, 11 Aug 2010 16:08:40 +0100 3856319 http://www.medworm.com/index.php?rid=3856320&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.fb.spyglas.rem.2.mpg.flv A 65 years old gentleman who is status post transduodenal ampullectomy for tubular adenoma about three months ago, presented to us with on and off abdominal pain and elevated serum amylase and lipase levels. CT scan of the abdomen showed the pancreas to be unremarkable: however, a linear structure was noted inside the main pancreatic duct. Scout film of the abdomen showed a millimeter thick linear structure in mid-abdomen. Attempts at removal by balloon sweep and biopsy forceps were unsuccessful. Next, peroral pancreatoscopy was performed. It revealed whitish-streaks inside the main pancreatic duct (most likely hyperplastic changes from the foreign body). Next, a linear whitish-green structure was noted inside the main pancreatic duct. The appearance was compatible with a surgical wire tha... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3856320 Wed, 11 Aug 2010 12:08:59 +0100 3856320 http://www.medworm.com/index.php?rid=3856318&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fwai_leong_quan_.sg-POC-in-B2.mov.flv This is a 68 yr old Chinese man with a background history of Billroth II gastrectomy presented recently with a severe acute cholangitis. An ERCP was performed and a plastic stent was inserted for biliary drainage. He has now returned for a repeat ERCP. The initial duodenoscopic view showed only one small opening which we thought would most likely represent the afferent limb. A more detailed search revealed another opening downstream which would probably lead us down the efferent limb although one cannot be sure at times and may need to adopt a trial-and-error approach. We then focused our attention on entering the presumed afferent limb. A combination of slow forward pushes with occasional withdrawal as well as repeated aspirations were made and we managed to reach the papilla withou... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3856318 Wed, 11 Aug 2010 09:08:58 +0100 3856318 http://www.medworm.com/index.php?rid=3630887&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fviswanathan-cjc-20100602.mov.flv Dr Prakash Viswanathan, Fellow at Stony Brook University Medical Center, presents journal club on the NEJM article published September 2009 titled "Capsule endoscopy versus colonoscopy for the detection of polyps and cancer". (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3630887 Sat, 05 Jun 2010 09:06:51 +0100 3630887 http://www.medworm.com/index.php?rid=3630890&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fschaefer_cfc_20100525.mov.flv Dr Esperance Shaefer, GI Fellow at Massachusetts General Hospital, presents selected clinical cases. The presentation was recorded 25 May 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3630890 Sat, 05 Jun 2010 09:06:48 +0100 3630890 http://www.medworm.com/index.php?rid=3630889&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fdeshpande_cfc_20100525.mov.flv Dr Vikram Deshpande, Assistant Professor of Pathology at Massachusetts General Hospital, reviews the pathology of GI neuroendocrine tumors. The presentation was recorded 25 May 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3630889 Sat, 05 Jun 2010 09:06:44 +0100 3630889 http://www.medworm.com/index.php?rid=3630888&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fsayedy-cjc-20100602.mov.flv Dr Leena Sayedy, Fellow at Stony Brook University Medical Center, presents journal club on the NEJM article published in January 2010 titled "Preoperative biliary drainage for cancer of the head of the pancreas". (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3630888 Sat, 05 Jun 2010 09:06:37 +0100 3630888 http://www.medworm.com/index.php?rid=3630891&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fpyachimski-RYGBstent3.mpg.flv The patient is a 66 year old male referred for evaluation of dysphagia. His medical history is notable for obesity and longstanding gastroesophageal reflux disease. He had undergone laparoscopic Roux en Y gastric bypass and Nissen fundoplication 5 years prior. Endoscopy demonstrated an adenocarcinoma at the gastroesophageal junction, staged as a T3 lesion by radial echoendosonography. The hypoechoic tumor can be seen extending through the muscularis propria layer of the esophagus. Despite treatment with chemotherapy and radiation, the patient experienced progressive disease, and several months later an esophageal stent placement was requested for palliation of dysphagia. Repeat endoscopy demonstrates an obstructing tumor in the distal esophagus. An ultraslim endoscope was selected for t... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3630891 Wed, 02 Jun 2010 17:06:15 +0100 3630891 http://www.medworm.com/index.php?rid=3623080&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fpyachimski-RYGBstent3.mpg.flv The patient is a 66 year old male referred for evaluation of dysphagia. His medical history is notable for obesity and longstanding gastroesophageal reflux disease. He had undergone laparoscopic Roux en Y gastric bypass and Nissen fundoplication 5 years prior. Endoscopy demonstrated an adenocarcinoma at the gastroesophageal junction, staged as a T3 lesion by radial echoendosonography. The hypoechoic tumor can be seen extending through the muscularis propria layer of the esophagus. Despite treatment with chemotherapy and radiation, the patient experienced progressive disease, and several months later an esophageal stent placement was requested for palliation of dysphagia. Repeat endoscopy demonstrates an obstructing tumor in the distal esophagus. An ultraslim endoscope was selected for t... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3623080 Wed, 02 Jun 2010 17:06:15 +0100 3623080 http://www.medworm.com/index.php?rid=3623081&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fgupta-EUScholedochoeditMAY.mpg.flv In this video we will describe a novel technique of EUS guided choledochoduodenostomy as a 1-step procedure using a echoendoscope. We perform this procedure in patients with unresectable malignancy causing obstructive jaundice. In patients where standard ERCP or EUS guided rendezvous has failed or is not an option. A detailed discussion with the family and the patient regarding the novel nature of the technique is explained. The risks, benefits and alternatives are also discussed in detail with the patient. We perform all procedures under general anesthesia for technical considerations and gastric outlet obstruction. Antibiotics are given to all patients. We prefer a therapeutic echoendoscope because of larger channel size. A 19 G needle gives an option of using different guide wires... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3623081 Wed, 02 Jun 2010 17:06:10 +0100 3623081 http://www.medworm.com/index.php?rid=3616014&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fbennetthooks-Ampullectomy4.mov.flv This 87-year-old female first presented to us with biliary obstruction 2 weeks after having aortic valve replacement. Plastic biliary stent was placed to relieve the obstruction and biopsies at the time revealed ampullary adenoma. Repeat ERCP with stent exchange and biopsies was performed confirming adenomatous tissue and EUS did not reveal any evidence of invasion of the adenoma. After multiple discussions with the patient and referring physicians she has chosen to undergo ampullectomy. After removing the biliary stent, inspection of the ampulla shows an abnormal papilla with adenomatous growth. We were able to cannulate the pancreatic duct prior to ampullectomy and injected contrast mixed with methylene blue into the pancreatic duct to facilitate finding the pancreatic orifice after... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3616014 Tue, 01 Jun 2010 07:06:31 +0100 3616014 http://www.medworm.com/index.php?rid=3593404&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fweinstein-cgr-20100518.mov.flv Dr Milena Weinstein, urogynecologist in the Vincent Department of Obstetrics and Gynecology at Massachusetts General Hospital, delivered clinical grand rounds for the MGH GI unit on the topic of pelvic organ prolapse. The presentation was recorded 18 May 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3593404 Mon, 24 May 2010 08:05:20 +0100 3593404 http://www.medworm.com/index.php?rid=3579103&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fsatish.nagula_Spiral-Rendezvous-ERCP.mp4.flv This is a 61 year old female with a history of pancreatic CA, s/p pylorus preserving Whipple, chemotherapy and radiation 20 years prior. She clinically has no evidence of disease. She has a 2 yr history of recurrent attacks of severe abdominal pain. These attacks of pain were self-limited episodes that lasted several hours. She was ultimately admitted to our hospital with abdominal pain, fever and jaundice. CT scan revealed a dilated common bile duct with surrounding inflammatory changes consistent with cholangitis. MRCP revealed the presence of a stricture at the choledochojejunal anastomosis. Spiral enteroscopy was performed. We were able to reach the blind end of the afferent limb, but were unable to identify the choledochojejunal anastomosis presumably due to the stricture. A percutane... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579103 Wed, 19 May 2010 14:05:53 +0100 3579103 http://www.medworm.com/index.php?rid=3575057&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fwolpin-cgr-20100511.mov.flv Dr Brian Wolpin, Instructor in Medcine at Harvard Medical School and Dana-Farber Cancer Institute, delivered clinical grand rounds at Massachusetts General Hospital GI Unit on 11 May 2010. The topic was risk markers for development of pancreatic cancer. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3575057 Wed, 19 May 2010 12:05:10 +0100 3575057 http://www.medworm.com/index.php?rid=3575059&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Ffreeman-cjc-20100411.mov.flv Dr Katherine Freeman, GI Fellow at Stony Brook Medical Center, reviews the recent article from the New England Journal of Medicine titled "Treatment with Monoclonal Antibodies Against Clostridium Difficile Toxins". This journal club was recorded 28 April 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3575059 Wed, 19 May 2010 11:05:44 +0100 3575059 http://www.medworm.com/index.php?rid=3575058&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fwilkinson-cjc-20100428.mov.flv Dr Mark Wilkinson, GI Fellow at Stony Brook Medical Center, reviews the recent article from the journal Gastroenterology titled "History of peptic ulcer disease and pancreatic cancer risk in men". This journal club was recorded 28 April 2010. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3575058 Wed, 19 May 2010 11:05:21 +0100 3575058 http://www.medworm.com/index.php?rid=3579111&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FU07-DDW2010.mpg.flv Conclusion This video demonstrates the successful creation of a gastro-gastric conduit after gastric bypass using simultaneous antegrade and retrograde endoscopy with fluoroscopic guidance. This technique can be used to reconnect the gastric pouch with the excluded stomach for endoscopic reversal of gastric bypass surgery, if required in select patients. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579111 Mon, 03 May 2010 16:05:13 +0100 3579111 http://www.medworm.com/index.php?rid=3579110&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FS05-DDW2010.mpg.flv Our patient is a 55 year old woman presenting with intermittent episodes of periumbilical abdominal pain and nausea of 2 months duration. She had extensive prior history of abdominal surgeries including ovarian cancer resection complicated by colonic perforation. This was treated with segmental colonic resection and temporizing ileostomy. Subsequently ileostomy take down and ileo-ileal anastamosis were performed. Last surgery was approximately 1 year ago. CT scan of the abdomen on presentation and on repeat scan 1 month later showed a large stone measuring 3 by 2 cm with a characteristic central hypodense core in the distal ileum. In addition a mild dilation of the ileum upto 3.2 cm was noted. There were no stones in a small gallbladder. Of note on a CAT scan done 6 months prior to pre... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579110 Mon, 03 May 2010 16:05:13 +0100 3579110 http://www.medworm.com/index.php?rid=3579109&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FP24-DDW2010.mpg.flv Biliopancreatic diversion is a morbid obesity surgery in which a long afferent loop is anastomosed to the ileum. It makes peroral ERCP impossible. Intraoperative ERCP through the distal antrum is feasible, and convenient if cholecystectomy is needed. A 72 y.o. female had prior cholecystectomy and biliopancreatic diversion with gastrectomy. She was offered a three step endoscopic approach for CBD stones. First, EUS-guided hepatico-gastrostomy, then cholangioscopy and lithotripsy through the hepatico-gastrostomy, and finally removal of residual stone fragments and biliary stents. Below the cardia the left bile duct is punctured under US, for cholangiography and guidewire insertion. Then a metal stent is advanced to the bileduct, and deployed across the gastric wall. A peripheral lef... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579109 Mon, 03 May 2010 16:05:13 +0100 3579109 http://www.medworm.com/index.php?rid=3579108&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FP21-DDW2010.mpg.flv We describe a stepwise approach to the endoscopic management of pancreaticojejunostomy strictures. Here we review the typical post-Whipple anatomy with three points of emphasis. First, the distance from the stomach to the anastomoses is widely variable. Patient factors, surgeon preference and the type of Whipple all impact the length. Second, there can be severe angulation within the surgically altered small bowel. And third, the pancreaticojejunostomy is typically found 5-7 cm beyond the biliary anatasomosis within the afferent limb. Our strategy is to start with a retrograde endoscopic approach. Depending on the length of the limb, we choose a standard duodenoscope or a device-assisted enteroscopic method, using either a double-balloon, single-balloon or rotational overtube. Our f... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579108 Mon, 03 May 2010 16:05:13 +0100 3579108 http://www.medworm.com/index.php?rid=3579107&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FP20-DDW2010.mpg.flv In conclusion, endoscopic sphincterotomy and a large balloon appears an effective and safe treatment for removal of difficult bile duct stones in patients with a Roux-en-Y anastomosis. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579107 Mon, 03 May 2010 16:05:13 +0100 3579107 http://www.medworm.com/index.php?rid=3579106&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FP16-DDW2010.mpg.flv We present a case of an 82-year-old woman, who underwent a Roux-en-Y gastric bypass 4 years earlier and lost 100 lbs. She was admitted to our hospital with one week of epigastric abdominal pain and jaundice. Laboratory analysis revealed a sudden rise of total bilirubin to 18.1 mg/dl. Her alkaline phosphatase was 268 U/L and ALT was 45 U/L. MRCP revealed marked intra- and extrahepatic biliary dilatation. The common bile duct measured 30mm, with a possible distal filling defect. The pancreatic duct was normal and no pancreatic masses were appreciated. The patient was referred for ERCP. Double balloon enteroscopy was performed. First the roux limb was navigated. The jejunojejunostomy anastomosis was encountered and 3 lumens were appreciated, reflecting a side-side anastomosis. One of ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579106 Mon, 03 May 2010 16:05:13 +0100 3579106 http://www.medworm.com/index.php?rid=3579105&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FP12-DDW2010.mpg.flv This study is to look at a recently introduced reusable fiber optic bundle which will fit through standard ERCP accessories. We wish to examine smaller ducts and see if these techniques could save costs and save time. An indication for this procedure may be looking at the common bile duct after lithotripsy. Here we see multiple fragments within a large duct which is difficult to completely clear. Here we have mounted a fiber optic bundle inside a balloon catheter for extraction. We have already extracted several pieces, and now with the balloon inflated, we have inserted this directly into the duct. By advancing the fiber optic bundle, through the balloon catheter, we are able to get excellent visualization in a duct that has just been cleared. Here we see cholesterolosis of the duct it... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579105 Mon, 03 May 2010 16:05:13 +0100 3579105 http://www.medworm.com/index.php?rid=3579104&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FO07-DDW2010.mpg.flv Gastrointestinal bleeding is an ominous complication associated with 5-10% mortality. Various methods have been developed for endoscopic control. (pause) Clips, cautery, APC, and injection therapy have been useful with good efficacy. Using principles established by these tools future devices may better address current limitations by enhancing tissue capture and providing greater compressive forces. Several novel endoscopic devices are under development may lead to improved endoscopic outcomes. These include memory clips, flexible suturing devices, high compression cautery, injectable polymers and telecommunicating biosensors. We first discuss specialized clips. Citinol clips have been used in experimental bleeding models. These are cut by electrical discharge machining and are... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3579104 Mon, 03 May 2010 16:05:13 +0100 3579104 http://www.medworm.com/index.php?rid=3527856&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FO06-DDW2010.mpg.flv Consider the benefits of looking inside the human body during an interventional procedure and seeing in real-time all anatomic structures in precise three-dimensional detail. This is what Image Guided Intervention technology provides its users. Image guided technologies allow for integration of imaging modalities and interventional procedures. Image guidance has been utilized in the fields of neurosurgery, general surgery and surgical oncology. Image guided techniques have been used for diagnosis, surgical guidance, intraoperative management, and therapy guidance. Until now, image guided intervention has been limited to non-flexible surgical tools. However, this technology may be useful for several endoscopic applications including training in EUS, ERCP, and colonoscopy as well as ser... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527856 Mon, 03 May 2010 16:05:13 +0100 3527856 http://www.medworm.com/index.php?rid=3527855&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FO04-DDW2010.mpg.flv The treatment of pancreatic pseudocysts has historically been managed by surgeons; however, endoscopic drainage of pancreatic pseudocysts by expert endoscopists has become an accepted alternative to surgery when an intervention is indicated. Its advantage over percutaneous drainage is the ability to place multiple internal drains with minimal patient discomfort through one puncture site and the avoidance of the development of a pancreaticocutaneous fistula. Today, I will be presenting a case of a 37 year-old male with no significant past medical history who developed acute pancreatitis after vacationing in the Bahamas. His pancreatitis was complicated by the formation of a pancreatic pseudocyst. The patient was treated with conservative therapy and had a peripherally inserted central c... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527855 Mon, 03 May 2010 16:05:13 +0100 3527855 http://www.medworm.com/index.php?rid=3527854&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FN08-DDW2010.mpg.flv Background/ Case: Magnets have previously been shown to be useful in endoscopic foreign body removal, EMR, and also in a NOTES surgical/navigation system. Endoscopic Methods: Thre endoscopic applications are presented that feature the novel use of rare-earth magnets. (1) NOTES magnetic retraction using and external magnet interacting with smaller endoscopically delivered magnets affixed to organs requiring retraction. (2) Magnetically, retrievable pancreaticobiliary stents, obviating the need for a follow-up endoscopy. (3) Compression anastomosis using endoscopically delivered, smart, self-assembling magnets. Clinical Implications: The applications presented herin offer potential solutions to (1) NOTES retraction, (2) pancreaticobiliary stent retrieval, and (3) endoscopoic m... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527854 Mon, 03 May 2010 16:05:13 +0100 3527854 http://www.medworm.com/index.php?rid=3527853&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FL12-DDW2010.mpg.flv A 50 year old man has a past medical history of bilateral congenital glaucoma causing him to be legally blind and metastatic rectal cancer to the liver. The patient's cancer was diagnosed because he had developed rectal obstruction. As a result, he underwent a diverting transverse loop colostomy. The patient had difficulty managing his ostomy because of his blindness. He requested resection of his rectal tumor in order to reverse his colostomy. Sixteen months after his previous surgery, he underwent a low anterior resection, reversal of his colostomy, and creation of a temporary loop ileostomy. Six months later, a barium enema was performed prior to his ileostomy takedown and the barium enema showed a widely patent rectal anastomosis. The patient was brought to the operating room... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527853 Mon, 03 May 2010 16:05:13 +0100 3527853 http://www.medworm.com/index.php?rid=3527852&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FL11-DDW2010.mpg.flv In conclusion, ESD with Flush-knife provided a safe and successfull en-bloc resection of this large rectal adenoma. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527852 Mon, 03 May 2010 16:05:13 +0100 3527852 http://www.medworm.com/index.php?rid=3527851&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FE08-DDW2010.mpg.flv In conclusion, this pilot study demonstrates the first clinical use of confocal laser endomicroscopy via a needle under EUS guidance. Access to pancreas lesions was technically feasible in all cases with no adverse events encountered. Visualization of structures including fibers, blood vessels and dark clumps and cells was achieved with good image quality. This technology may permit real-time CLE imaging of multiple areas accessible via EUS-FNA. Further study correlating CLE, cytology and surgical pathology findings is warranted. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527851 Mon, 03 May 2010 16:05:13 +0100 3527851 http://www.medworm.com/index.php?rid=3527850&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FE06-DDW2010.mpg.flv Experience with a prototype forward-viewing curvilinear array therapeutic echoendoscope for interventional EUS: a case series. Interventional EUS offers a minimally invasive alternative to traditional surgical and/or radiologic interventions for the treatment of pancreaticobiliary disorders. These procedures are typically performed with oblique-viewing instruments. However, standard oblique-viewing echoendoscopes are limited by impaired endoscopic visualization, difficult orientation for drainage procedures and difficulty passing accessories through the endoscope channel. Recent development of a forward-viewing therapeutic echoendoscope may offer advantages over standard oblique viewing instruments by improving endoscopic visualization, optimizing access to pseudocysts, bile ducts... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527850 Mon, 03 May 2010 16:05:13 +0100 3527850 http://www.medworm.com/index.php?rid=3527849&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FE05-DDW2010.mpg.flv This video aims to demonstrate the EUS-assisted access to a peripancreatic abscess and subsequent drainage into the stomach in addition to the use of hydrogen peroxide to facilitate removal of necrotic debris. A 26 year old female patient presented with LUQ abdominal pain of two months duration. Her past medical history was significant for obesity, endometriosis and a cholecystectomy. A CT scan of the abdomen showed a 2 cm cystic lesion in the pancreatic tail with no septation. The patient underwent laparoscopic distal pancreatectomy and splenectomy and pathology confirmed the diagnosis of mucinous cystic neoplasm. Three weeks postoperatively the patient was diagnosed with a subphrenic abscess after she presented with fevers and abdominal pain. The abscess was initially drained pe... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527849 Mon, 03 May 2010 16:05:13 +0100 3527849 http://www.medworm.com/index.php?rid=3527848&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FE04_DDW2010.mpg.flv This was a 30 year-old Caucasian-American male who had a past medical history that was significant for community acquired pneumonia and migraines. He presented to the clinic with a chief complaint of dysphagia for solids and weight loss. Chest x-rays both of the PA and lateral view were negative and without lymphadenopathy. A CT scan of the thorax was performed and was significant for the presence of a 2.8 x 2.9 cm mass in the sub carinal region causing external compression of the esophagus. An upper endoscopy was performed which revealed intraluminal bulging as seen here. Linear endoscopic ultrasound was performed and was significant for the presence of a 3 x 3cm mediastinal mass extending into the esophagus, creating external compression. FNA was then performed with a 19 gauge needle... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527848 Mon, 03 May 2010 16:05:13 +0100 3527848 http://www.medworm.com/index.php?rid=3527847&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FE01_DDW2010.mpg.flv In conclusion, EUS-guided transesophageal access to fundal varices is feasible and appears safe. Transesophageal delivery of coils and glue is feasible and appears safe. The transesophageal approach has several practical advantages over conventional access to fundal varices in retroflexion Coil deployment prior to glue oblieration may eliminate the risk of glue embolization. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3527847 Mon, 03 May 2010 16:05:13 +0100 3527847 http://www.medworm.com/index.php?rid=3477255&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fpriya.jamida-Minor_papilla_44.mpg.flv A 65 year old female had multiple episodes of recurrent acute pancreatitis. Endoscopic ultrasound (EUS) examination showed pancreas divisum. From the second portion of the duodenum, the slow withdrawal of the endoscope was performed to visualize the minor papilla. Minor papilla examination was performed in the long position of the endoscope, which provides more stable position. Very careful examination was performed on the minor papilla, in attempt to visualize the opening. A Cremmer catheter was used to gently probe the minor papilla in attempt to visualize the opening. But after few attempts, we were still unable to see the opening of the minor papilla. It is important to re-confirm the relationship of the minor papilla to the major papilla. The scope was gently inserted and withdrawn to... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3477255 Sat, 17 Apr 2010 09:04:44 +0100 3477255 http://www.medworm.com/index.php?rid=3477254&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fsiqbal50_pancreas-divisum.mpg.flv Pancreas divisum is a congenital abnormality that is seen in upto 7% of patients undergoing ERCP. It results from lack of fusion of ventral and dorsal pancreatic ducts. As shown in the MRCP images, the CBD and main PD do not join at major ampulla. This video will demonstrate the technique of endoscopic treatment of pancreas divisum. Ventral pancreatic duct is first cannulated via major papilla, with the endoscope in short position. The duct is short, and does not cross the midline of spine. It is important to differentiate pancreas divisum from pancreatic stricture by minor papilla cannulation. Next, the dorsal duct is cannulated via minor papilla with guidewire assistance. A 0.025 or 0.035 inch guidewire is passed into the dorsal duct with the endoscope in long position. Note the forma... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3477254 Sat, 17 Apr 2010 09:04:26 +0100 3477254 http://www.medworm.com/index.php?rid=3495710&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FDellon-cryoablationBE-DAVE.mpg.flv This video will review the equipment and technique for cryoablation of Barrett's esophagus with high grade dysplasia, including set-up, priming the catheter, placing the decompression tube, and performing cryoablation. Prior to the procedure, the cryoablation unit is filled with liquid nitrogen. The unit itself has an indicator panel which displays the cryotherapy duration, as well as passive and active suction used to rapidly remove excess nitrogen gas from the stomach during treatment. The liquid nitrogen spray is delivered through a special catheter designed to withstand freezing temperatures. When primed, liquid nitrogen gas is rapidly released from the catheter tip. After equipment set-up, the next step is to examine the esophagus to delineate the extent of the Barrett&#... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3495710 Thu, 15 Apr 2010 09:04:47 +0100 3495710 http://www.medworm.com/index.php?rid=3469451&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2FDellon-cryoablationBE-DAVE.mpg.flv This video will review the equipment and technique for cryoablation of Barrett's esophagus with high grade dysplasia, including set-up, priming the catheter, placing the decompression tube, and performing cryoablation. Prior to the procedure, the cryoablation unit is filled with liquid nitrogen. The unit itself has an indicator panel which displays the cryotherapy duration, as well as passive and active suction used to rapidly remove excess nitrogen gas from the stomach during treatment. The liquid nitrogen spray is delivered through a special catheter designed to withstand freezing temperatures. When primed, liquid nitrogen gas is rapidly released from the catheter tip. After equipment set-up, the next step is to examine the esophagus to delineate the extent of the Barrett&#... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3469451 Thu, 15 Apr 2010 09:04:47 +0100 3469451 http://www.medworm.com/index.php?rid=3469453&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.d.dup.ooo.ooo.bio.1ro.pa1002us.mpg.flv A 50 year old male with chief complaint of post-prandial vague abdominal pain had a capsule endoscopy exam, which showed submucosal mass in the proximal small bowel. Upper endoscopy showed a 2 cm submucosal bulge in the third portion of the duodenum occupying 1/4th of the lumen with normal overlying mucosa. This lesion was soft and collapsed somewhat when probed with a closed biopsy forceps. Endoscopic ultrasound (EUS) examination done with 12mHz miniprobe showed anechoic homogenous cyst in the submucosa measuring 16 mm x 14 mm in size with normal overlying mucosa, deep mucosa and normal underlying muscularis propria. These images again show the soft compressible lesion in the duodenum. Upon biopsy a cloudy, milky fluid was seen coming out of the submucosal bulge resulting in the decompres... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3469453 Thu, 15 Apr 2010 09:04:41 +0100 3469453 http://www.medworm.com/index.php?rid=3469452&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fbadihe_LesserSacAccess.mp4.flv This video demonstrates the experimental technique for endosonographic access to the lesser sac in human cadavers – an opportunity for transgastric endoscopic pancreatic surgery. It should be noted that this video depicts an experimental technique that is not currently intended for use outside of a research protocol. Transluminal endoscopic intervention in the lesser sac is routinely performed in clinical practice as a method of draining pancreatic pseudocysts, as demonstrated in the footage on the right side, and debriding walled-off pancreatic necrosis, as demonstrated on the left side of the screen. In these cases, the cyst cavity provides both a target for transluminal access as well as a natural working space for intervention. Transgastric endoscopic access in the abs... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3469452 Thu, 15 Apr 2010 09:04:07 +0100 3469452 http://www.medworm.com/index.php?rid=3438741&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.Linitis.Plastica.mp4.flv 85 year old male was recently diagnosed with gastric adenocarcinoma. His past medical history included coronary artery disease; he underwent coronary bypass surgery, hypertension, benign prostate hyperplasia, and asthma. Family history was significant for gastric cancer in his nephew. He had history of smoking in the past. Upper endoscopy showed diffusely prominent proximal gastric folds. The examination of the antrum and pylorus showed normal looking gastric mucosa. Again, on withdrawal distinct transition point was seen in antrum and proximal body. Similar changes were seen in the fundus of the stomach. These are the narrow band imaging of the prominent gastric folds in the proximal body. The narrow band imaging showed cobblestone pattern of the gastric mucosa with normal pit pattern... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3438741 Mon, 05 Apr 2010 14:04:33 +0100 3438741 http://www.medworm.com/index.php?rid=3438742&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.EUS.neuroendocrine.tumor.mp4.flv A 33 yo female underwent imaging of the abdomen with a CT scan of the abdomen to evaluate abdominal pain. A mass in the tail of the pancreas with increased uptake on octreotide scan was identified. EUS identified a well circumscribed, 3 cm mass superior to the kidney in the pancreas tail. A central cystic space was seen within the mass along with areas of vascularity. The mass was separate from the splenic vessels. EUS-FNA cytology was consistent with a neuroendocrine neoplasm. A laparoscopic distal pancreatectomy and splenectomy was performed. Surgical pathology revealed a pancreatic endocrine neoplasm. Immunohistochemical staining was positive for chromogranin, synaptophysin, CD56 and glucagon, indicating an endocrine alpha cell tumor. (Source: The Digital Atlas of Video Education... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3438742 Mon, 05 Apr 2010 13:04:44 +0100 3438742 http://www.medworm.com/index.php?rid=3438743&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.MALTOMA.mp4.flv A 54 year old male was referred due to gastric submucosal lesions seen on the recent endoscopic examination. Endoscopic examination of the stomach showed multiple, nodular lesions predominantly involving the antrum and distal body. A bi-lobed mass like area was seen at the angularis with normal looking overlying mucosa. A small, clean based ulcer was seen at this mass like area. Narrow band imaging examination showed slight irregularity of the gastric pit pattern. Radial endoscopic examination of the gastric antrum showed diffuse thickening of the deep mucosa as pointed out by the solid arrow. The submucosal layer was not involved. The open arrow shows the muscularis propria. Detailed circumferential examination of the gastric layers was performed in a systematic way. Examination of the ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3438743 Mon, 05 Apr 2010 13:04:28 +0100 3438743 http://www.medworm.com/index.php?rid=3438744&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.s.umar.ascaris.mpg.flv This abnormality was encountered on upper Endoscopy of this 35 year old female who complained of Epigastric pain and Dyspepsia. This worm is Ascaris lubricoides - the most common of the intestinal nematodes. Measuring 15-35cm in length. When ingested, unfertilized eggs are not infective. Fertile eggs embryonate and become infective after 18 days to several weeks. Once swallowed, the larvae hatch and invade the intestinal mucosa and are carried to the lungs via portal and systemic circulation. After maturing in the lungs in about two weeks, larvae penetrate the alveolar walls and ascend the bronchial tree to the throat and are swallowed. They develop into adult worms in the small intestine and reside there for six to twenty-four months. They can remain asymptomatic, cause intestinal ob... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3438744 Mon, 05 Apr 2010 13:04:17 +0100 3438744 http://www.medworm.com/index.php?rid=3364630&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.verrucous.ca.vinnu.mpg.flv A 65 year old male presented with 1 yr history of dysphagia. An upper endoscopy showed white wart like appearing exudative lesions involving the mid and lower esophagus. The entire esophageal mucosa was friable. The appearance is more extensive in the lower esophagus with luminal narrowing but without any obstruction. Here you can see that the lesion extended through the GE junction into the gastric cardia. The biopsies from this lesion showed foci of hyperkeratosis and parakeratosis with moderate to severe atypia. This was suspicious for verrucous carcinoma. An endoscopic ultrasound performed using a radial echoendoscope showed thick circumferential hypoechoeic lesion arising from the mucosa and extending to the muscularis propria. Here one can appreciate the thickened submucosa up to ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3364630 Sun, 14 Mar 2010 16:03:49 +0100 3364630 http://www.medworm.com/index.php?rid=3363302&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fbuscaglia.T-G.fistula.mpg.flv A 49 year-old man underwent a recent esophagectomy for esophageal cancer. His postoperative course was complicated by a fistula between the trachea and the intra-thoracic stomach. A previously placed tracheal stent was unsuccessful at sealing the fistula. Using argon plasma coagulation, the perimeter of the opening is ablated in order to de-epithelialize the tissue and promote complete sealing of the fistula after approximating its edges. Endoscopic hemoclips are placed around the border of the fistula, and a detachable snare--or endoscopic polyloop--is used to approximate the edges of the defect. Following this, a flexible guidewire is placed within the intra-thoracic stomach. The endoscope is withdrawn, and the site of the fistula can be identified by the hemoclips. Under simultaneous ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3363302 Sat, 13 Mar 2010 14:03:02 +0100 3363302 http://www.medworm.com/index.php?rid=3375892&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.i.pol.pjs.pec.5.mpg.flv A 30 year old woman with Peutz-Jegher syndrome presented with nausea, vomiting and crampy left abdominal pain. She had undergone multiple abdominal surgeries since child hood for intussuception of the small bowel due to large hamartomatous polyps. Her physical exam was remarkable for tachycardia, hyperpigmented spots on her lips and an abdomen tender to deep palpation with no rebound tenderness. A computer tomography of the abdomen and pelvis showed gastric polyps and dilated loops of bowel with obstruction from large polypoid lesions. A target sign was present. After the benefits and risks of surgery were explained to the patient, she elected endoscopy with double balloon enteroscopy with polypectomy to avoid surgery and maintain small bowel function. Both upper and lower endosc... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3375892 Thu, 21 Jan 2010 08:01:33 +0100 3375892 http://www.medworm.com/index.php?rid=3195367&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.i.pol.pjs.pec.5.mpg.flv A 30 year old woman with Peutz-Jegher syndrome presented with nausea, vomiting and crampy left abdominal pain. She had undergone multiple abdominal surgeries since child hood for intussuception of the small bowel due to large hamartomatous polyps. Her physical exam was remarkable for tachycardia, hyperpigmented spots on her lips and an abdomen tender to deep palpation with no rebound tenderness. A computer tomography of the abdomen and pelvis showed gastric polyps and dilated loops of bowel with obstruction from large polypoid lesions. A target sign was present. After the benefits and risks of surgery were explained to the patient, she elected endoscopy with double balloon enteroscopy with polypectomy to avoid surgery and maintain small bowel function. Both upper and lower endosc... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3195367 Thu, 21 Jan 2010 08:01:33 +0100 3195367 http://www.medworm.com/index.php?rid=3187031&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.d.div.obs.cli.nif.1oo.ke0508us.mpg.flv A 24 year old female was referred for complaints intermittent nausea and vomiting and weight loss. The upper GI barium study demonstrates an enlarged diverticulum in the second portion of the duodenum. A thin radiolucent stripe is seen around the diverticulum which has been described as the halo sign. Upper endoscopy is performed which identifies a large diverticulum which intermittently obstructs the duodenal lumen. The endoscopic appearance is consistent with a windsock diverticulum. This intraluminal diverticulum is thought to result from incomplete recanalization of the duodenum during embryological development and with complete obstruction, symptoms present during childhood. In contrast, when there is a small aperture in the duodenum, patients may initially remain asymptomatic. Howeve... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3187031 Tue, 19 Jan 2010 09:01:09 +0100 3187031 http://www.medworm.com/index.php?rid=3165266&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.i.apx.oo.oo.eus.0903bu.mpg.flv On routine examination of the cecum during screening colonoscopy, a 76 year-old man is noted to have a small amount of polypoid tissue extruding from the appendiceal orifice. The lesion is submerged in water and a 20 MHz, high-frequency, EUS probe is used for further evaluation. EUS allows for easy sonographic identification of the polyp. The bright white, hyperechoic portions of the colonic wall correspond to the submucosal layer; thus making this polyp a superficial, mucosal-based lesion. The polyp is then grasped with a standard biopsy forceps in order to expose all points of involvement within the appendiceal lumen for complete inspection. (Source: The Digital Atlas of Video Education - Gastroenterology) The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3165266 Wed, 13 Jan 2010 11:01:52 +0100 3165266 http://www.medworm.com/index.php?rid=3064636&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.can.guide.wire.pa0912us.mpg.flv In this video we will present two cases discussing the technique of bile duct access with pure wire guided cannulation using a loop tip guide wire. For pure wire guided cannulation, a sphincterotome is recommended. We should stay slightly away from the papilla so that papilla is clearly visualized and using the bow of sphincterotome the guide wire can be advanced in a cephalad direction over the septum in the direction of the bile duct. Loop-tip guidewire is a 0.035 inch guide wire with an atraumatic tip . The loop at end prevents dissection of the tissue and prevents puncturing of pancreatic duct. The radio-opacity of the guide wire tells us the duct accessed without injecting contrast. Also, the guide wire has enough stiffness for adequate pushing force. This schematic diagram shows how ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3064636 Tue, 08 Dec 2009 10:12:08 +0100 3064636 http://www.medworm.com/index.php?rid=3014033&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.bal.dil.stn.pa0911.mpg.flv 83 year old male with multiple co-morbidities presented with fever, abnormal liver enzymes and dilated common bile duct (CBD) up to 15 mm in size on abdominal CT scan and elevated international normalized ratio (INR). A pull type sphincterotome was used to cannulate the common bile duct. After the slight adjustment, the sphincterotome was advanced freely without any resistance into the common bile duct and the cholangiogram was obtained. Here we see a large common bile duct stone on the cholangiogram. This stone was approximately 15 mm in size. A small biliary sphincterotomy was performed using the endocut current. We used controlled radial expansion (CRE) balloon over the guidewire to dilate the biliary orifice. We inflated the CRE balloon up to 12 mm and was kept in position for appro... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3014033 Fri, 20 Nov 2009 16:11:33 +0100 3014033 http://www.medworm.com/index.php?rid=3183575&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.eus.fna.mas.sto0911.mpg.flv A 67 year old man was referred for an EUS of an incidental pancreatic mass lesion. His past medical history included a colorectal cancer resected 18 year ago. He was admitted to the hospital 1 month prior to the EUS for one episode of melaena. He had no weight loss and was otherwise well. He had a normal gastroscopy and colonoscopy and a capsule endoscopy showed a small bowel polyp. To further investigate this polyp the patient had a CT abdomen that did not show the polyp but that revealed a 1.6 cm well defined mass in the neck of the pancreas (figure 1,2). On EUS a well defined 1.6 cm homogenous hypoechoic mass with a central calcification was seen in the neck of the pancreas. The pancreatic duct was mildly dilated in the body and tail. There were no enlarged lymph nodes and the live... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3183575 Fri, 20 Nov 2009 15:11:39 +0100 3183575 http://www.medworm.com/index.php?rid=3183576&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.es.stent.bu0910.mpg.flv ERCP is attempted for transpapillary drainage of a communicating pseudocyst. Cannulation of the pancreatic orifice is performed using a standard sphincterotome. Injection pancreatogram reveals a gush of contrast extravasating from the main pancreatic duct. A large amount of contrast is seen pooling behind the endoscope. A decision is made to perform a pancreatic sphincterotomy and place a pancreatic duct stent. Using a guidewire technique, the sphincterotome cutting wire is positioned in the 12 o'clock to 1 o'clock position to cut the pancreatic portion of the sphincter of Oddi. In order to expose more of the intraduodenal portion of the sphincter muscle, the sphincterotome is contracted, or bowed, within the proximal pancreatic duct while simultaneously withdrawing the instrument ... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=3183576 Fri, 20 Nov 2009 15:11:16 +0100 3183576 http://www.medworm.com/index.php?rid=2972543&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.c.eus.0910bu.mpg.flv A 72 year-old man is found to have a rectal adenocarcinoma on screening colonoscopy. CT scan of the abdomen and pelvis is performed and shows evidence of rectal wall thickening without associated lymphadenopathy. Subsequent PET scan shows increased activity in the rectum only. Staging pull-through EUS examination is then performed. Radial imaging at 7.5 MHz shows clear identification of the bladder. Upon pull-through with the EUS scope, the rectal wall is identified showing the muscularis propria and a thickened submucosal space suggesting tumor involvement. The tumor appears to extend through the muscularis propria, shown here at the 6 o'clock position. As the probe is withdrawn further, there is easy identification of the seminal vesicles. Upon withdrawal of the EUS scope towards the... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=2972543 Mon, 09 Nov 2009 11:11:57 +0100 2972543 http://www.medworm.com/index.php?rid=2932539&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fbadihe_endoscopic-necrosectomy.mpg.flv The patient is a 61 year-old gentleman with multiple medical problems, including end stage renal disease requiring a deceased donor kidney transplant, who developed walled-off pancreatic necrosis four months after an episode of severe gallstone pancreatitis. He developed progressive anorexia, early satiety, and post-prandial nausea, leading to profound weight loss despite nutritional supplementation and pancreatic enzyme replacement. Abdominal computed tomography (CT) scan revealed a 15 cm x 5 cm collection of necrotic debris and gas replacing the majority of the pancreatic parenchyma. A prolonged trial of percutaneous drainage failed to resolve the collection and resulted in a pancreatic-percutaneous fistula. Because of the patient's multiple comorbidities, compromised nut... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=2932539 Wed, 28 Oct 2009 10:10:48 +0100 2932539 http://www.medworm.com/index.php?rid=2932540&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fjaganmohan.band.lig.varic.ra200801f.mpg.flv A 53-year old female with hepatitis C, alcohol abuse, and child C cirrhosis presented with hematemesis for one day. Vital signs on admission were a blood pressure of 100/66 and heart rate of 110. Laboratory results were hemoglobin: 10 g/dL, platelets: 89,000, and INR: 2.8. She had a previous history of esophageal varices without any bleeding or history of variceal banding. Initial management consisted of packed red blood cells, IV Octreotide, a proton pump inhibitor, antibiotics, fresh frozen plasma, vitamin K, Erythromycin. Emergent endoscopy was undertaken. As the scope enters the gastroesophageal junction, an actively spurting vessel is seen at 2 o'clock on the screen in the cardia. Here is the retroflexed view also showing bleeding from the cardia. After evaluation of the rest o... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=2932540 Wed, 28 Oct 2009 10:10:12 +0100 2932540 http://www.medworm.com/index.php?rid=2910206&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.i.pig.ooo.ooo.bio.1op.br060613.mpg.flv During a routine endoscopy for Barrett's related dysplasia surveillance, this mucosal abnormality was identified. On endoscopy, these pigmented areas of mucosa in the antrum, pylorus, and duodenum were seen. This is the classic endoscopic finding of pseudomelanosis of the gastrointestinal tract, whose features include a brownish-black pigmentation of the mucosa in a non-inflamed, random, speckled pattern. There is no apparent associated mucosal thickening or other defects. Pseudomelanosis has been observed to occur anywhere along the length of the gastrointestinal tract. The pigment of pseudomelanosis has not been completely characterized although ferrous sulfide is commonly found on staining. A recent case series demonstrated that the majority of these patients are taking oral iron... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=2910206 Wed, 21 Oct 2009 13:10:15 +0100 2910206 http://www.medworm.com/index.php?rid=2903729&cid=s_34966_17_f&fid=34966&url=http%3A%2F%2Fdaveproject.org%2Fmedia%2Fvideos%2F512k%2F480x320%2Fflash%2Fevca.p.pancCA.cpn.mpg.flv Author: Mohamad A. Eloubeidi, M.D., M.H.S., F.A.C.P., F.A.C.G. Associate Professor of Medicine and Pathology Director, Endoscopic Ultrasound Program Co-Director Pancreatico-biliary Center Institution: University of Alabama at Birmingham Department of Medicine Division of Gastroenterology/Hepatology Statement of COI: Dr. Eloubeidi reports no conflicts of interests relating to this video presentation We have a 62 year old lady with pancreatic cancer diagnosed two weeks ago. We started her on Loritab but unfortunately it did not help her pain. During last examination by EUS and by CT scan of abdomen there is clear evidence of involvement of the celiac artery and therefore she is not amenable for surgical evaluation and surgical resection. We counseled her regarding the... The Digital Atlas of Video Education - Gastroenterology news http://www.medworm.com/rss/comments.php?id=2903729 Mon, 19 Oct 2009 13:14:13 +0100 2903729