Video Journal and Encyclopedia of GI Endoscopy最新文献

Hyperplastic polyposis is a rare syndrome characterized by the development of multiple colorectal serrated lesions, most often a mixture of hyperplastic polyps and flat serrated adenomas. Patients with hyperplastic polyposis syndrome (HPS) have a high lifetime risk of developing colorectal cancer (up to 50%). However, at colonoscopy the diagnosis is often missed because the flat lesions are not recognized or the endoscopist is simply unaware of this syndrome. Here the author presents three cases with HPS and demonstrates the typical endoscopic features. This article is part of an expert video encyclopedia.

Chronic radiation-induced colonic injury occurs in up to 20% of patients following radiotherapy. The rectum and distal sigmoid colon are most susceptible to radiation damage, and chronic radiation proctopathy generally manifests with anorectal pain, diarrhea, rectal bleeding, and/or anemia. Endoscopic findings include loss of mucosal vasculature, patchy erythema, and angioectasia, which correlate with ischemic endarteritis of the submucosal arterioles, submucosal fibrosis, and angioectasia on histopathological examination. Although most patients develop symptomatic chronic radiation proctopathy within 1–2 years after radiation exposure, they can present up to 30 years after treatment. Radiation proctopathy, found incidentally during endoscopy, does not warrant any therapy. Argon plasma coagulation (APC) is the mainstay of endoscopic therapy for chronic radiation proctopathy. Laser therapy and dilute formalin (2–10%) application are associated with higher complications and are not commonly utilized. In this video presentation, endoscopic findings are described in chronic radiation proctopathy and colopathy as well as APC therapy. This article is part of an expert video encyclopedia.

In patients with jaundice and unsuccessful biliary drainage with cholangiopancreatography because of inaccessible papilla due to duodenal stenosis caused by tumor invasion, endoscopic ultrasound (EUS)-guided biliary drainage has been introduced as an alternative to percutaneous cholangiodrainage (PTCD). Here is demonstrated an EUS-guided choledochoduodenostomy in a patient with local advanced pancreatic carcinoma. This article is part of an expert video encyclopedia.

Colonic diverticulosis is one of the most common conditions in industrialized nations. At colonoscopy, passage of the sigmoid can be challenging and complex in patients with diverticulosis, especially when they harbor plenty and large diverticula. Large diverticular openings can mimic the colonic. We demonstrate the colonoscopic passage through a colon with massive diverticulosis. This article is part of an expert video encyclopedia.

This is a demonstration of endoscopic retrograde cholangiopancreatography and cholangioscopy with endoscopic placement of a biliary plastic stent in a 64-year-old woman with a first diagnosis of a cholangiocarcinoma classifed as Bismuth type I. The information presented here allows understanding of the precise technique needed for successful biliary stenting using straight plastic endoprosthesis. This article is part of an expert video encyclopedia.

For safe and reproducible endoscopic submucosal dissection (ESD) procedure, the appropriate dissection of the ramified vascular network in the level of the middle submucosal layer is required to reach the avascular stratum just above the muscle layer. The horizontal approach to maintain the appropriate depth for dissection beneath the vascular network enables treatment of difficult cases with large vessels and severe fibrosis. This article is part of an expert video encyclopedia.

Here the authors report the case of an elderly woman who had upper abdominal pain, upper gastrointestinal hemorrhage, and jaundice (a symptomatic triad termed the ‘Quincke’ triad) a few days after endoscopic sphincterotomy. Abdominal ultrasonography demonstrated an echo-rich filling of the choledochus consistent with hemobilia. Endoscopic retrograde cholangiography was immediately performed and blood clots were removed from the common bile duct. A nasobiliary catheter was placed to irrigate the bile duct for prevention of recurring obstruction of the bile ducts from blood clots. Further follow-up of the patient was uneventful. This article is part of an expert video encyclopedia.

Patients with ulcerative colitis are at an increased risk for the development of colitis-associated cancer. Therefore, surveillance in these patients is of crucial importance. Dysplasia in ulcerative colitis is often flat and surrounded by normal-appearing mucosa. Therefore, careful endoscopic inspection is important. Recent data indicate that advanced endoscopic imaging modalities have the potential to improve dysplasia detection in ulcerative colitis. This video focuses on the technique and application of advanced endoscopic imaging modalities for the early detection of dysplasia in ulcerative colitis, including dye-based and dye-less chromoendoscopy, magnification endoscopy, endocytoscopy, and confocal laser endomicroscopy. This article is part of an expert video encyclopedia.