RESUMO
We propose this variant of the clip technique as a method that assist traction during endoscopic submucosal dissection (ESD): traction on the mucosa plane using an hemoclip carrying a surgical silk and three rubber bands, before the incision, to allow easier access to the submucosa space. We propose this variant with the intention of facilitating access to ESD quickly and safely for beginners.
Assuntos
Ressecção Endoscópica de Mucosa , Humanos , Ressecção Endoscópica de Mucosa/métodos , Resultado do Tratamento , Dissecação/métodos , Mucosa , Instrumentos CirúrgicosRESUMO
Biliary fully-covered self-expandable metal stents (FCSEMS) can be used for benign conditions since they can be removed. Uncovered SEMS (uSEMS) are employed for malignant biliary obstruction and are intended to be permanent. Furthermore, they are almost impossible to remove because they become embedded in the bile duct. We present a technique for uSEMS removal in a patient in whom a biliary uSEMS had been inserted for two years. Biliary obstruction due pancreatic cancer was misdiagnosed. Finally an IgG4 related-disease (autoimmune pancreatitis) was identified.
Assuntos
Colestase , Neoplasias Pancreáticas , Stents Metálicos Autoexpansíveis , Colangiopancreatografia Retrógrada Endoscópica , Humanos , StentsRESUMO
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Assuntos
Humanos , Masculino , Idoso de 80 Anos ou mais , Divertículo/diagnóstico por imagem , Duodenopatias/complicações , Divertículo/complicações , Hemorragia Gastrointestinal/terapia , Duodeno/diagnóstico por imagem , Duodeno/patologia , /terapia , Eletrocoagulação/métodos , Epinefrina/uso terapêuticoRESUMO
We report the case of a patient with a Dieulafoy lesion within a duodenal diverticulum, showing the radiographic images. In this case the use of radiological techniques was of great help for diagnosis, bearing in mind that bleeding from this lesion may be intermittent and had not been revealed by the first endoscopic procedure. Since strong clinical suspicion persisted of active upper GI bleeding an angio-CT scan was performed, which allowed to orient diagnosis and rule out other causes of bleeding inaccessible to endoscopy.
Assuntos
Divertículo , Gastroenteropatias , Doenças Vasculares , Divertículo/complicações , Divertículo/diagnóstico por imagem , Divertículo/cirurgia , Endoscopia , Hemorragia Gastrointestinal/diagnóstico por imagem , Hemorragia Gastrointestinal/etiologia , HumanosRESUMO
Endoscopic ultrasound-guided transluminal drainage (EUS-TD) has become the standard of care for the treatment of peripancreatic fluid collections (PFCs). New lumen-apposing metal stents (LAMS) have facilitated the drainage technique . However, this fact should not cloud our view when planning a EUS-TD, as occasionally things are not what they seem.
