Video Journal and Encyclopedia of GI Endoscopy最新文献

Solitary rectal ulcer syndrome (SRUS) can be a great mimicker of serious disorders such as carcinoma and inflammatory bowel diseases. The final diagnosis of SRUS is made by biopsy. Endoscopic ultrasound can help in the evaluation and differentiation in SRUS. This article is part of an expert video encyclopedia.

Rectal carcinoid tumors smaller than 10 mm in diameter and located within the submucosal layer have a negligible risk of lymph node involvement and distant metastasis and are suitable for endoscopic treatment. Here the authors have shown an endoscopic ultrasonography for evaluating the size and depth of carcinoid tumors and endoscopic submucosal dissection for en bloc resection. This article is part of an expert video encyclopedia.

Ninety percent of patients with intraductal biliary stones are successfully treated with sphincterotomy and subsequent stone extraction. However, technical difficulty increases with stone size and giant stones require fragmentation to facilitate endoscopic removal. For stones too large to be engaged in a basket for mechanical lithotripsy, laser and electrohydraulic lithotripsy have been proposed for stone fragmentation. Application of electrohydraulic lithotripsy (EHL) is best achieved under direct visualization during cholangioscopy, because shock waves can also injure normal tissue. We present the case of a patient who underwent direct cholangioscopy for EHL of a giant stone that could not be retrieved by endoscopic retrograde cholangiopancreatography (ERCP). This article is part of an expert video encyclopedia.

Endoscopic tattooing is one of the most useful tools for the localization of small colorectal lesions, especially in the laparoscopic setting. This minimally invasive endoscopic procedure has a low risk of complications, provided that the injection technique is performed adequately. Here the author demonstrates the procedure, as well as the macroscopic appearance of the tattoo and its appearance 6 weeks later. This article is part of an expert video encyclopedia.

Appendiceal mucocele (AM) is a descriptive term for dilated appendiceal lumen, occasionally observed in either symptomatic or asymptomatic patients during colonoscopy. Endoscopically, AM looks like submucosal tumor of the cecum, and may mimic lipoma, gastrointestinal stromal tumor, or neuroendocrine tumor. Etiological factors range from inflammatory to neoplastic, and right hemicolectomy is the treatment of choice. The biopsy of lesion during colonoscopy should be avoided to prevent serious complications at surgery; preoperative diagnosis by other imaging studies should be confirmed. Here a patient is presented with symptomatic AM. This article is part of an expert video encyclopedia.

Vessels of large colonic polyps often cause postpolypectomy hemorrhage. Preligation with endoloop increases the current density and coagulates more at the site of preligation as compared with at the site of polypectomy. Ligation of stalks after polypectomy is very difficult. The Anchor clip keeps the stalk after polypectomy; in addition, the Anchor clip also suppresses the rolling up, which makes it easy to ligate the stalk. The partially placed Anchor clip draws the electrical current, avoiding burn injury around the Endoclips at the site of the polypectomy. The Anchor clip technique allows easy and safe prevention of postpolypectomy hemorrhage. This article is part of an expert video encyclopedia.

Conventional mother–baby cholangioscopy has never gained wide acceptance and is available only in a minority of referral centers as the technology is technically difficult and expensive. Direct cholangioscopy (without a mother technology) using standard ultraslim endoscopes for biliary access is a novel, fascinating approach that could overcome several limitations of conventional cholangioscopy: It is a 1-operator procedure, there is no need for a second light source and processor, it provides excellent high-resolution images, and devices are equipped with a 2.0-mm diameter that allows the insertion of larger biopsy forceps and the use of a variety of endoscopic retrograde cholangopancreatography accessories. A direct cholangioscopy is demonstrated in a 45-year-old male patient who was admitted for painless jaundice after laparoscopic cholecystectomy for acute acalculous cholecystitis 6 weeks ago. This article is part of an expert video encyclopedia.

Endoscopic retrograde cholangiopancreatography (ERCP) is probably the most challenging procedure in endoscopy. Here the author demonstrates the technique of positioning the side-viewing endoscope in the duodenum, and cannulating the common bile duct and the pancreatic duct in a patient referred for ERCP for abdominal colic. This article is part of an expert video encyclopedia.

Small bowel endoscopy is indicated for patients with an unidentified bleeding site in esophago-gastro-duodenoscopy and ileo-colonoscopy and symptoms of intestinal blood loss or unexplained anemia. In approximately two-thirds of these cases, capsule endoscopy (CE) detects a lesion within the small bowel that explains the patient's symptoms. In few cases, though, lesions outside of the small bowel might be revealed by CE. Therefore, attention to all intestines that are visualized by CE might be necessary not to overlook bleeding sites that had not been discovered by prior flexible endoscopy.

The authors present the case of a 71-year-old male patient who presented to their outpatient clinic for unexplained anemia. Small bowel CE revealed minor bleeding from an adenocarcinoma in the cecum. This article is part of an expert video encyclopedia.