Todani, choledochal cysts:
I Extrahepatic dilation, most common (50-85%)
II Supraduodenal diverticulum (2%)
III Choledochocele
IV Multiple: IVa intra + extra, IVb extra only
V Intrahepatic only; multiple = Caroli
PBM is more common in I and IV.
I Extrahepatic dilation, most common (50-85%)
II Supraduodenal diverticulum (2%)
III Choledochocele
IV Multiple: IVa intra + extra, IVb extra only
V Intrahepatic only; multiple = Caroli
PBM is more common in I and IV.
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Pancreatic juice refluxing into the bile duct causes strictures, more dilation and cancer. The lecture case: endocollab.com/blogs/full-cou…
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138
Dysphagia and normal mucosa?
Biopsy anyway.
4-14-4: take 4 biopsies at 14 cm and 4 at 4 cm above the esophagogastric junction.
Put each set in a separate container.
Source: North Danish Region consensus, September 2011.
Biopsy anyway.
4-14-4: take 4 biopsies at 14 cm and 4 at 4 cm above the esophagogastric junction.
Put each set in a separate container.
Source: North Danish Region consensus, September 2011.
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3
20
996
EndoCollab Quiz
You perform an endoscopic mucosal resection, inspect the resection site and find this.
What do you do?
a. Nothing
b. Close with clips
c. Call the surgeon for colon resection
Vote in the reply to see the answer.
You perform an endoscopic mucosal resection, inspect the resection site and find this.
What do you do?
a. Nothing
b. Close with clips
c. Call the surgeon for colon resection
Vote in the reply to see the answer.
1
0
7
1,357
Answer in our Telegram quiz. Vote to see it:
t.me/endocollab/124
t.me/endocollab/124
0
0
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397
TUBE-IN-TUBE EVT SALVAGE
Mediastinal leaks look catastrophic but heal rapidly with negative pressure.
- Outer: Large bore tube (tissue protection)
- Inner: Suction catheter with MANUAL side holes
- Seal: Must be 100% airtight
PRO TIP:
Manually cutting extra side fenestrations
Mediastinal leaks look catastrophic but heal rapidly with negative pressure.
- Outer: Large bore tube (tissue protection)
- Inner: Suction catheter with MANUAL side holes
- Seal: Must be 100% airtight
PRO TIP:
Manually cutting extra side fenestrations
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904
EndoCollab™ | GI Endoscopy Community retweeted
Bleeding after sphincterotomy.
71-year-old woman. Plastic biliary stents for a malignant stricture.
How it was stopped is in the thread.
71-year-old woman. Plastic biliary stents for a malignant stricture.
How it was stopped is in the thread.
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EndoCollab™ | GI Endoscopy Community retweeted
Two inlet patches facing each other in the upper esophagus.
Gastric heterotopia, more visible under NBI. They usually sit close to the upper esophageal sphincter, so a distal cap keeps the entrance open for APC.
By Jay Bapaye, MD and Klaus Mönkemüller, MD, PhD
Gastric heterotopia, more visible under NBI. They usually sit close to the upper esophageal sphincter, so a distal cap keeps the entrance open for APC.
By Jay Bapaye, MD and Klaus Mönkemüller, MD, PhD
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EndoCollab™ | GI Endoscopy Community retweeted
Phrygian cap gallbladder: the most common congenital gallbladder anomaly (4%). It can mimic a liver mass but is benign. Case by Klaus Mönkemüller, MD, PhD.
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Stubborn rectal fecaloma at colonoscopy?
Klaus Mönkemüller on Coca-Cola instillation through the scope: it can dissolve it. Under 500 ml, bubbles are fine. Over 500 ml, shake it first to take the carbonation out.
Members' views, not a guideline.
© EndoCollab
Klaus Mönkemüller on Coca-Cola instillation through the scope: it can dissolve it. Under 500 ml, bubbles are fine. Over 500 ml, shake it first to take the carbonation out.
Members' views, not a guideline.
© EndoCollab
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2
10
2,165
WASP in 2 steps:
1 NICE: brown color, brown vessels or oval tubular/branched surface? No = NICE 1, yes = NICE 2.
2 Two of: clouded surface, indistinctive border, irregular shape, dark spots inside crypts?
Yes: SSL. No: hyperplastic (NICE 1) or adenoma (NICE 2).
1 NICE: brown color, brown vessels or oval tubular/branched surface? No = NICE 1, yes = NICE 2.
2 Two of: clouded surface, indistinctive border, irregular shape, dark spots inside crypts?
Yes: SSL. No: hyperplastic (NICE 1) or adenoma (NICE 2).
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2
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A NICE Type 2 polyp can still be sessile serrated. Check the four features every time: endocollab.com/train-your-eye…
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1
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163
EndoCollab Quiz
Elderly patient with severe iron-deficiency anemia. EGD showed this ulcerated mass in the stomach.
Diagnosis?
a. Gastric adenocarcinoma
b. T-cell lymphoma
c. GIST
d. Neuroendocrine tumor (carcinoid)
e. B-cell lymphoma
Vote in the reply to see the answer.
Elderly patient with severe iron-deficiency anemia. EGD showed this ulcerated mass in the stomach.
Diagnosis?
a. Gastric adenocarcinoma
b. T-cell lymphoma
c. GIST
d. Neuroendocrine tumor (carcinoid)
e. B-cell lymphoma
Vote in the reply to see the answer.
6
1
8
1,896
Answer in our Telegram quiz. Vote to see it:
t.me/endocollab/122
t.me/endocollab/122
0
0
0
436
Prague Criteria: measuring Barrett's esophagus
Find the GEJ by depth of insertion: tops of gastric mucosal folds, sphincter "pinch" = 36 cm.
Subtract the 33 cm circumferential and 29 cm maximum extents from it: C3 and M7.
Source: IWGCO.
Find the GEJ by depth of insertion: tops of gastric mucosal folds, sphincter "pinch" = 36 cm.
Subtract the 33 cm circumferential and 29 cm maximum extents from it: C3 and M7.
Source: IWGCO.
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43
1,725
EndoCollab™ | GI Endoscopy Community retweeted
Zenker's diverticulum: more often than not, a thick septum and a barely visible esophageal lumen.
The fix: a wire or a thin feeding tube into the stomach. It keeps the lumen in view for a controlled septotomy.
By Jay Bapaye, MD and Klaus Mönkemüller, MD, PhD
The fix: a wire or a thin feeding tube into the stomach. It keeps the lumen in view for a controlled septotomy.
By Jay Bapaye, MD and Klaus Mönkemüller, MD, PhD
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Quick Tip Video on EndoCollab
Scope Positioning During Bile Duct Stone Extraction
The Leverage Movement
Scope Positioning During Bile Duct Stone Extraction
The Leverage Movement
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941
GAVE is often misclassified because its look varies.
The EndoCollab classification has 5 types:
1. Linear
2. Honeycomb
3. Nodular
4. Giant folds
5. Mixed
Do not confuse it with portal hypertensive gastropathy: fine reticular "snakeskin" mucosa. Electrocoagulation does not control PHG bleeding.
The EndoCollab classification has 5 types:
1. Linear
2. Honeycomb
3. Nodular
4. Giant folds
5. Mixed
Do not confuse it with portal hypertensive gastropathy: fine reticular "snakeskin" mucosa. Electrocoagulation does not control PHG bleeding.
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15
1,567
From Chapter 13 of The EndoCollab Guide for GI Bleeding: Spectrum of Gastric Antral Vascular Ectasia (GAVE) (Watermelon Stomach). A 224-page atlas of real cases by Klaus Mönkemüller and colleagues. Get it on Amazon: amazon.com/dp/B0FFQ5FYLR
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169
Modified Schutz scale, ERCP complexity, one example per grade:
1 Deep cannulation
2 Biliary stone extraction under 10 mm
3 Biliary stone extraction over 10 mm
4 ERCP after Whipple or Roux-en-Y bariatric surgery
Add one grade (max 4): after hours, post-Billroth II, prior failure
1 Deep cannulation
2 Biliary stone extraction under 10 mm
3 Biliary stone extraction over 10 mm
4 ERCP after Whipple or Roux-en-Y bariatric surgery
Add one grade (max 4): after hours, post-Billroth II, prior failure
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Device-assisted and rendezvous ERCP are not on the scale. Klaus Mönkemüller calls them level 5, extreme ERCP: endocollab.com/blogs/full-cou…
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196