EndoCollab™ | GI Endoscopy Community

Become a better endoscopist with EndoCollab, the world's most comprehensive endoscopy community.

Join us:

[The Practicing Endoscopist @theendoscopist]

Cirrhosis, hematemesis and melena for one day. EGD shows this varix.

Which sign is it?
A) Red spots
B) Red wale sign
C) Nipple sign
D) Active bleeding

The case, and why the authors banded quickly, by Rami Musallam, MD and Klaus Mönkemüller, MD, PhD:

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

From Chapter 30 of The EndoCollab Guide for GI Bleeding: Abdominal Pain, Jaundice and Melena: Think of Hemobilia. A 224-page atlas of real cases by Klaus Mönkemüller and colleagues. Get it on Amazon: https://t.co/CHbVsgJkp3

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Abdominal pain, jaundice and melena the day after a liver biopsy? Think hemobilia.

Only 22% of patients show the full triad. It is often missed because the papilla is not closely inspected on EGD.

Tip: use a distal transparent cap or a side-viewing duodenoscope.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

The full atlas, first 13 minutes free: https://t.co/8ZhUsWF28g

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Dynamic injection for a submucosal cushion has two parts.

The nurse pulses the syringe.

You move the needle, the wheels, and the shaft, so the blue mix spreads under the whole polyp.

From Klaus Mönkemüller's new 66-minute atlas of the complex colon polyp.

[The Practicing Endoscopist @theendoscopist]

The snare keeps slipping off a flat lesion.

Pre-cutting EMR (hybrid ESD-EMR) in 3 steps:
1. Inject a submucosal cushion
2. Incise around the lesion with the snare tip (usually 1-2 mm exposure)
3. Snare in the groove and resect

Full technique by Klaus Mönkemüller, MD, PhD:

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

How a cholangiogram corresponds to liver segments.

Numbers indicate drained hepatic segments.

Adapted from Pauli et al. Arch Surg 2012 (Diagram), and Abdominal Key (cholangiogram).

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

EndoCollab Quiz

This lesion was located in the upper esophagus, just distal to the upper esophageal sphincter, at about 17 cm from the incisors.

What's your diagnosis?

Reply below with your answer.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Classification of Serrated Polyps: Features, Histology, and Endoscopic Appearance.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Common Types of Pancreatic Cysts and Their Characteristics

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Closure of complex gastro-colo-cutaneous fistula with two scopes

- Case
- Procedures
- Wire through second oostomy-fistula
- Localization of the orifice of the fistula
- Closed with Clips TTS
- Fistula closed with 12/6 OTSC

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Patient with intermittent abdominal pain.

Colonoscopy showed this.

What is the diagnosis?

A. Gastrointestinal stromal tumor (GIST)
B. Neuroendocrine tumor (carcinoid)
C. Inverted diverticulum
D. Large lipoma causing intermittent obstruction

Comment your letter first.

Then check the answer in the first comment.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Los Angeles Classification of Reflux Esophagitis.

Grades A to D are defined by:
The length of the mucosal break
Whether it extends between the tops of mucosal folds
Whether it involves at least 75% of the esophageal circumference

Adapted from IWGCO.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Klaus teaches this at 16:17 in his new 66-minute atlas, The Complex Colon Polyp: https://t.co/uCBg2XGGHZ

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

"Four-quadrant" injection is a myth.

Two anterior injections can give an adequate submucosal lift. Injecting from behind is not always mandatory.

From Klaus Mönkemüller's Complex Colon Polyps lecture, Panama.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

👉 How to Create The Ideal India Ink Tattoo

[The Practicing Endoscopist @theendoscopist]

Find the bleeding source.

Duodenum case: recurrent overt GI bleeding, and two previous EGDs without significant findings. On the third look: active bleeding, no ulceration or angiodysplasia. Hemostasis with a through-the-scope clip.

Full case by Klaus Mönkemüller, MD, PhD:

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Join EndoCollab: https://t.co/5ldcnC414W

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

Stuck distal stent? Overtube and cap extraction.

After dilating past a filiform stricture, use an overtube plus distal cap.

Grasp the stent, pull it into the cap and overtube, and extract through that giant working channel to avoid laceration.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

EndoCollab Quiz

What type of varices are these, based on the Sarin classification?

Reply below with your answer.