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internal medicine knowledge: esophageal varices

August 12, 2017

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internal medicine knowledge: esophageal varices

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DO YOU USE SNARE for precut sphincterotomy before?

Snare as precut- sphincterotomy A 62-year-old man presented with obstructive jaundice and underwent ERCP. Multiple trials of cannulation failed. The Snare-made sphincterotomy (precut and sphincterotomy knife NOT available during the ERCP). The papilla is located at the bottom of a duodenal diverticulum. Cholangiography revealed dilated CBD, but there were no stones. Cleaning using an extraction balloon revealed cholangitis with the passage of pus.

colonoscopy for beginners (young gastroenterologists)

#colonoscopy for beginners colonoscopy demonstration retroflexion #piles #ileal intubation young #gastroenterologists

calm before the storm

Calm before the storm. A 75-year-old man underwent an upper digestive endoscopy because of a massive attack of hematemesis five days ago. The hemoglobin level was 4 gm/ dl. A blood transfusion was given, and hemoglobin is 9 gm/dl. The patient has a history of chronic liver disease and an upper digestive endoscopy two years ago. The index endoscopy revealed gastric varices that were injected with amacrylate. The second endoscope revealed a sizeable gastric varix with a bleeding point (triangular in part 1 of the video). Just after identification, the varix begins to bleed during the endoscopy (part 2, beginning of the storm). The varix was secured with five ampoules of the amacrylate (part 3 of the video). After the injection of amacrylate, another storm (volcano) of bleeding started. The endoscopist injected the varix again with five ampoules of amacrylate. This time, you can notice the glue protruding from the bleeding point (arrow). After the endoscopy, the patient was admitted to th

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