EUS in Pancreatic Tumors
Tumor Note the maximal dimensions, border irregularity, echo-texture, and presence of solid/cystic components in the tumor Vascular invasion Pancreatic head tumor: note the relationship of the tumor with the portal…
Rectal Cancer and Anal Sphincter Disorders
Fig. 27.1 Management algorithm for nonmetastatic primary rectal cancer (ESD endoscopic submucosal dissection) The diagnostic accuracy of EUS in rectal cancer staging has recently been questioned and criticized as clinical…
Gastric Cancer and Thickened Gastric Wall
Fig. 26.1 Endoscopic images of a gastric cancer. White light a and chromoendoscopy with indigo carmine b show a shallow depressed lesion in the anterior wall of the antrum What…
Endoscopic Management of Complications in Acute Pancreatitis
Fig. 12.1 Types of pancreatic and peripancreatic collections based on the revised Atlanta classification system of acute pancreatitis with representative contrast-enhanced CT images. Collections are differentiated by the presence or…
Bleeding from the Papilla
Iatrogenic Liver biopsy Transhepatic cholangiography Transhepatic ablative therapy Transhepatic biliary drainage Cholecystectomy Bile duct surgery Endoscopic retrograde cholangiopancreatography (ERCP) manipulation (stenting, sphincterotomy, biopsy, lithotripsy, stricture dilation, etc.) Trauma Penetrating injury…
Other Benign Biliary Strictures: Sclerosing Cholangitis, Autoimmune Cholangitis, Post-Liver Transplant
Benign intrinsic Malignant intrinsic Iatrogenic injury (i.e., post-surgical) Cholangiocarcinoma Primary sclerosing cholangitis Biliary IPMN Autoimmune cholangiopathy (i.e., IgG4-associated) Biliary involvement of ampullary carcinoma Inflammatory Chloroma Ischemic cholangiopathy Myeloma Fibroinflammtory biliary…
ERCP in Post-Surgical Patients
Fig. 17.1 Standard scope length and distance from the mouth to the biliary orifice following surgical alteration of the gastrointestinal tract. BPD biliopancreatic diversion, RYGBP Roux-en-Y gastric bypass procedure Table…
Endoscopic Ultrasound-Guided Fine-Needle Injection
Fig. 33.1 EUS image of celiac artery ( arrow) and SMA ( arrowhead) taking off from the aorta. (Courtesy Dr. Linda Lee, Brigham and Women’s Hospital, Boston, MA) EUS-Guided Direct…
Idiopathic Acute Pancreatitis and Sphincter of Oddi Dysfunction: Diagnostic and Therapeutic Role of ERCP and Sphincter of Oddi Manometry
Fig. 14.1 A flow diagram showing the initial investigations that should be performed for acute pancreatitis. * Smoking is an independent risk factor for AP; † A specific threshold for…
EUS-Guided Bilio-Pancreatic Drainage
Fig. 34.1 6F cystostome (Endoflex Company) Dilators are required to enlarge the fistula tract following puncture. Bougie (6-7F) or balloon (4–6 mm) dilators such as the Soehendra biliary dilation catheter (Cook…
