JOSFER

Medico Especialista en Medicina Interna y en Gastroenterologia Fellowship Oncologia Digestiva Ecografía Abdominal.Apasionado por la EII. Papá de Aurora y Matias

[Mohammad A. Khaskia, MD, MRCP(UK) @M_Almohamady]

🧵 POEM tunnel entry — tips for a clean start (1/4)
Dynamic injection: withdraw the needle gradually during injection until the bleb nearly fills the endoscopic view — your signal that the cushion is adequate.
#POEM #Endoscopy #Achalasia
@sinderelamanar @SaadRafea @ahmad_madkour

[Aleksandar Gavric @GavricAle]

First STER @GI_UMCLJ @ukclj

58-year-old woman presented with dysphagia and was referred to us by thoracic surgeons. A 25 mm esophageal leiomyoma was identified and successfully removed from the esophagus (22 cm from the incisors).

[Achintya Singh, MD @AchintyaSinghMD]

An 8 cm stent may not remain 8 cm after deployment!

A crucial concept in stent selection: Foreshortening

Most commonly used SEMS are braided (e.g. WallFlex).

As they expand, they shorten in length—sometimes by as much as 40%.

In contrast, laser-cut stents are fashioned from a single metal tube and exhibit minimal foreshortening.

The tradeoff? Greater axial force and often more patient discomfort.

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

🍉 Ligadura endoscópica con bandas para estómago en sandía

[Frontline Gastro @FrontGastro_BMJ]

🚨 New in Frontline Gastroenterology

Are GLP-1 receptor agonists safe and effective in patients with IBD?

This systematic review & meta-analysis of 23 studies including >150,000 patients found GLP-1 RAs were associated with:

⬇️ BMI
⬇️ IBD-related surgery
⬇️ IBD-related hospitalisation
✅ No signal of IBD worsening

GI adverse effects remain important, with discontinuation reported in 11–24% of patients.

An important and timely synthesis as obesity and metabolic disease become increasingly relevant in IBD care.

🔗 https://t.co/y4TofrJktM

@PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @AmCollegeGastro @Aegastro @SAGES_updates @WAGE_media @my_UEG @amergastroassn @NASPGHAN @UHSEndoscopy @ESGE_news @amergastroassn @BritSocGastro

[Ash Almomani, MD @AlmomaniMD]

For intermittent dysphagia, always insufflate the stomach well to look for Schatzki ring (hiatal hernia).

It’s called a “sliding” hernia because it slides up & down with changes in intra-abdominal pressure. If the patient coughs, that’s usually your best shot!

#GITwitter #MedTwitter #MedEd #Endoscopy

[Ali Rezaie MD MSc @AliRezaieMD]

Stubbornly clogged gastrostomy tubes usually don't have a chance vs a scope cleaning brush!
(22F PEG unclogged with Avanos 5mm brush)

[JOSFER @JOSFER2011]

@alexbadbunnys Ayer también estaba justo en el palco de al lado
Estaba en Palco Privado y hoy fue otra vez jajaja
Que crack

[AESPANC @AESPANC]

🚨📢¡RECIÉN PUBLICADAS!

Primeras guías ibero-latinoamericanas de #PancreatitisAguda (#iLATAM-AP), fruto del trabajo conjunto de expertos de España, Portugal y Latinoamérica.

🧵Abrimos hilo con las recomendaciones clave👇

@aegastro @OPGEgastro @sied_online @AESPANC @SP_Gastro

[Ash Almomani, MD @AlmomaniMD]

Recurrent symptomatic HP gastric polyp after 2 prior challenging conventional EMRs. That’s why I favor band-assisted EMR for antral/prepyloric lesions <15 mm.

The band captures mucosa & submucosa (+\- superficial MP), making it generally safe to cut BELOW the band (wider margins).

#GITwitter #MedTwitter #MedEd #Endoscopy #EMR

[Fouad Jaber, MD, MS, D-ABOM @fouadsjaber]

👏 Great hands on sessions on third space and ESD. Learnt a lot from the best Drs. @PrashantKediaMD @TomTielleman @SanchezLunaMD @NehmeFredy @WasAbiDoc @gastrowala

🙏 Thanks for the course director Dr. @EndoscopyOthman , co-directors Drs. @GiJawaid @FaresAyoubMD @KeihanianTara , Philip Ge, Emmanuel Coronel and all faculty @shifaumarMD @alhaddad_mo @rjsealock @MahamHayatMD

@TexasIEG @tmcddc @IUGastro @bcm_gihep #GITwitter #MedTwitter @methodistdallas

[Aleksandar Gavric @GavricAle]

What can go wrong when tattooing the colon?

I was always focused on not injecting it too aggressively.

This one seemed neat, but I went too “supra-submucosally,” as a few weeks later during surgery there was no tattoo.

As everywhere: the best path is in the middle.

[EndoCollab™ | GI Endoscopy Community @EndoCollabcom]

A tip every GI trainee should hear early:

When performing submucosal injection, don't just rely on preloaded syringes. Mix your own by adding a few drops of indigo carmine or methylene blue to saline.

Saline mixed with blue dye is a highly effective, low-cost solution.

[The Baveno Cooperation: an EASL Consortium @BavenoCoop]

📜 Preventing decompensation in cACLD — Baveno VIII 🗣️ @bogdanprocopet | #EASLCongress
🔬 PH = main driver of decompensation
⚠️ Ascites = most common &amp; deadliest event
💡 Treat the etiology → ↓PH → ↓decompensation risk
💊 NSBBs (carvedilol) → ↓ decompensation (ascites)

[Asociación Española para el Estudio del Hígado @AEEHLiver]

💫 Compartimos esta infografía, muy completa, sobre "Recomendaciones sobre el diagnóstico de pacientes con el virus de la hepatitis delta (VHD) en España".

💯Un documento en colaboración con la #AEE, @SEIMC_ , @GEHEP_seimc, @semfyc y la @Sanidad_Peniten . 👌

[Sociedad Española de Patología Digestiva (SEPD) @sepdigestiva]

Manifestaciones cutáneas de la #EII

Fuente: https://t.co/8CGp7c5EfN

[Ash Almomani, MD @AlmomaniMD]

During endoscopic stricture dilation, always try to inspect the balloon closely from within. This will allow you to foresee potential complications before deflation.

NEVER advance to the next 1mm without first assessing the effect of the prior dilation.

#GITwitter #MedTwitter #Endoscopy #MedED

[Enrique de-Madaria @DeMadaria]

Hola a todos. Hoy se ha publicado una noticia en la que se informa de que he recibido un premio en Estados Unidos y se comenta, con buena fe, que es equivalente al premio Nobel en el aparato digestivo.

En realidad, se trata de que en el congreso americano de Digestivo se consideró uno de nuestros trabajos como uno de los seis mejores de todos los presentados en gastroenterología. Esto no es equivalente ni mucho menos a algo como un premio Nobel de Digestivo. Como os digo, solo había buena fe detrás de los periodistas, que siempre nos ayudan día tras día a visibilizar nuestros trabajos de investigación y nuestros proyectos como la carrera del cáncer de páncreas, y les estoy eternamente agradecido; lo hemos aclarado esta misma mañana, pero quería matizarlo.

[Klaus Mönkemüller, MD, PhD @KMonkemuller]

✂️ How to perform cap-assisted &amp; band resection of Barrett‘s dysplasia using the Duette Device

✅ I explain you everything you need to know about Barrett‘s and it’s diagnosis and treatment on https://t.co/xFwGDc0u73

@endocollab @theendoscopist

[ASGE GI Endoscopy @ASGEendoscopy]

Editor’s Choice: Han Jo Jeon and colleagues display "A novel robotic arm–assisted endoscopic submucosal dissection platform with augmented traction for gastric neoplasms: a first-in-human prospective pilot study (with videos)." Read the article here: https://t.co/VAdaByDWgj. #GITwitter #GIE #GIEJournal