An Uncommon Cause of Acute Jaundice

ERCP of Giant Santorinicele in Setting of Pancreas Divisum

Prophylactic Clipping for Polyps

Risk of Recurrent Gallstone Disease after Pregnancy

Endoscopic Detection and Resection of Sessile Serrated Lesions

This patient was referred for removal of 3 cecal lesions detected on screening colonoscopy.

This video highlights the subtlety and multiplicity of serrated lesions in the right colon. Furthermore, they are known to be difficult to resect due to their indistinct borders and flat nature (Pohl H et al, Gastro, 2013). Saline injection with dilute dye can be helpful in the identification of neoplastic borders and facilitate safe resection.

Endoscopic Removal of a Curtain Hook Impacted in the Esophagus

Managing foreign bodies in the GI tract requires understanding what the object looks like and being careful not to injury the intestinal tract. Overtubes are preferable to use but the size of some objects may not allow this.

A 50 year old woman was transferred from an outside hospital with a history of swallowing a curtain hook at her psychiatric facility. Chest x-ray demonstrates two sharp edges, one facing towards the mouth and one on the gastric side. Endoscopic removal is requested with surgical back-up. Patient was discharged the next day after normal esophagram.

Avoiding Unnecessary Surgery

This 60 year old female had a screening colonoscopy at her local hospital. The endoscopist identified this polyp as suspicious for carcinoma, tattooed it, and biopsied it. Pathology was an inflammatory polyp. Surprisingly, she was referred for surgery and the surgeon recommended a right hemicolectomy. She correctly sought another opinion and her surgeon at our institution referred her for endoscopic resection. Final pathology of this 2 cm pedunculated polyp is a retention polyp. This is an entirely benign polyp.

Needle Knife Sphincterotomy

Generally, biliary access can be achieved with standard cannulation techniques. However, in some cases, other techniques may be required. This is a case where biliary access can not be achieved and a PD stent can not be placed to facilitate cannulation. Therefore, a freehand pre-cut sphincterotomy is performed for biliary access.

Removing a Retained Video Capsule

A 30 year old female underwent video capsule endoscopy for anemia. The capsule did not reach the cecum and follow-up radiographs confirm it is retained in the suspected jejunum. Peroral enteroscopy is performed to identify the cause of capsule retention and retrieve the capsule.

Endoscopic Management of Chronic Pancreatitis

Endoscopic therapy for chronic pancreatitis can be particularly effective in the presence of large duct chronic pancreatitis. Although surgery is more durable, many patients choose to undergo endoscopic therapy. This is an example of a 33-year old patient with chronic calcific pancreatitis from hereditary pancreatitis and a very distal PD stricture.