Dedication
Acknowledgments
About the Editors
Contributing Authors
Preface
Foreword |
| Section I. | Upper Endoscopy |
| Question 1. | An 81-Year-Old Healthy Male is Found to Have a 12-cm Long Segment Barrett´s Esophagus and Several Tiny Raised Lesions. Biopsy Shows Moderate- to High-Grade Dysplasia in one Location. How Should I Advise this Patient About this Prognosis? Which Surgical or Endoscopic Therapies Would Be Appropriate to Consider? How Can I Tell Whether or Not a Small Cancer Has Been Missed in the Biopsy?
Fauze Maluf-Filho, MD, and Paulo Sakai |
| Question 2. | Is Endoscopic Biopsy of the Duodenum or Jejunum Necessary for the Diagnosis of Celiac Disease if the Serum Anti-Tissue Transglutaminase Antibody Is Positive? Is Capsule Endoscopy Good Enough to Make the Diagnosis? When and How Should I Investigate for Complications of Celiac Disease?
Carol E. Semrad, MD |
| Question 3. | A 46-Year-Old Female with Cirrhosis Came in with Severe Upper GI Bleeding. Her Proximal Stomach Is Filled with Large Clots and Gastric Varices Are Suspected. How Can I Tell for Certain Endoscopically, and How Should I Treat It?
Kanat Ransibrahmanakul, MD, and Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Question 4. | Is My Impression Correct that Endoscopic GERD Treatment Is a Thing of the Past? If So, Why? For Which Endoscopic Method Should I Refer Patients?
Christopher J. Gostout, MD |
| Question 5. | What Are the Recommendations for Performing the Various Endoscopies in a Pregnant Woman?
John Baillie, MB, ChB, FRCP, FACG, FASGE |
| Question 6. | What Are the Essential Tools for Removing Esophagogastric Foreign Bodies, and When Should I Apply These Devices?
Wang Luo-wei, MD, PhD, and Li Zhao-shen, MD |
| Question 7. | I Was Washing and Suctioning to Get a Good Look at the Gastroesophageal Junction Varices and They Started to Bleed. I Could Not See Where the Bleeding Came From. What Should I Do?
John S. Goff, MD |
| Question 8. | What Is the Current Recommendation for Endoscopic Surveillance of Barrett´s Esophagus, and How Can We Improve the Results with the Current Technologies? The Role of Magnifying Endoscopy, Chromoendoscopy, or NBI in Barrett´s Surveillance.
Paulo Sakai and Fauze Maluf Filho |
| Question 9. | You Were Called by the ER Physician Regarding a Woman who Attempted to Commit Suicide by Drinking some “Toilet Cleaning Solution.” There Were Obvious Burns Around the Mouth and Tongue. What Would You Do Next?
Rajesh Gupta, MD, DM, and D. Nageshwar Reddy, MD, DM, FRCP, DSc |
| Question 10. | What Is the Best Treatment for Duodenal or Ampullary Adenoma, and What Is the Current Recommendation for Surveillance After Treatment?
Richard A. Kozarek, MD |
| Question 11. | What Should I Do if I have Inadvertently Perforated the Viscus During an Endoscopy?
Gregory Haber, MD |
| Question 12. | Is Fluoroscopy Absolutely Necessary for Dilation of Esophageal Stricture and Placement of Esophageal Stent?
Terry Jue, MD, and Walter Trudeau, MD |
| Question 13. | I Have a Patient with Advanced HIV and Severe Odynophagia. He has Failed an Empiric Course of Fluconazole. What Agents Commonly Cause Odynophagia in this Population?
John P. Cello, MD |
| Question 14. | What Is the Current Expert Opinion on What Hemostasis Technique to Use in Treating a Visible Vessel or Dieulafoy Lesion? When Should I Involve a Surgeon?
Sanjay Hegde, MD and Michael L. Kochman, MD |
| Section II. | Colonoscopy |
| Question 15. | Which of My Patients with Ulcerative Colitis Need “Surveillance” Colonoscopy? If They Are Well Managed on Stable Doses of Medication, Why Do They Need Elective Colonoscopy?
Francis A. Farraye, MD, MSc |
| Question 16. | I Seem to Find Many Flat Polyps in the Cecum and Rectum of my Patients. How Should I Treat Them Other than Sending Them to Surgery, Which Seems a Little Excessive?
Jerome D. Waye, MD |
| Question 17. | I Frequently Get Calls to Decompress a Distended Colon and the Radiologist is Unsure if It Is a Volvulus or Pseudo-Obstruction. How Should I Approach this Technically? What Is the Role of the GI in These Conditions, and When Is a Surgical Opinion Needed?
Nirmal S. Mann, MD, MS, PhD, DSc, FRCPC, FACG, MACP |
| Question 18. | What Do People Do for Treatment of Achalasia These Days? Does It Matter if the Symptoms Are Severe or if the Patient Is Elderly?
Terry Jue, MD, and Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Question 19. | What Is the Best Bowel Preparation and Timing for an Emergency Colonoscopy for GI Bleeding?
Jerome D. Waye, MD |
| Section III. | ERCP |
| Question 20. | I Have a Patient with a Post Cholecystectomy Bile Leak and Treated Him With a 7 French Stent. Four Days Later, His JP Drain Still Puts Out 300 cc/Day. What Is the Problem and What Should Be Done?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE, and Simon K. Lo, MD, FACP |
| Question 21. | Is There a Role for Metal Stents in Benign Bile Duct Strictures? When Should I Use Plastic Stents in this Setting?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Question 22. | Why Is Balloon Sphincteroplasty Still Being Practiced, and When Should We Consider this Treatment Option?
Rajesh Gupta, MD, DM, and D. Nageshwar Reddy, MD, DM, FRCP, DSc |
| Question 23. | How Do We Manage a Patient with a 10-cm Pseudocyst Who Is Currently Asymptomatic?
Richard A. Kozarek, MD |
| Question 24. | What if the Pancreatic Cyst has Persisted for More than a Year and is Not Resolving?
Richard A. Kozarek, MD |
| Question 25. | What is Best Endoscopic Method to Diagnose Pancreatic Cancer? What Is the Best Way to Sample Tissue to Diagnose Suspected Bile Duct Cancer?
John Lee |
| Question 26. | What Is the Role of Plastic Versus Metal Stents in Patients with Hilar Bile Duct Obstruction? Is There a Need for Bilateral Stenting for Malignant Hilar Obstruction?
Gregory Haber, MD |
| Question 27. | An Elderly Patient with Multiple Medical Problems Presented with Acute Pancreatitis with Stones in the Gallbladder. Her Liver Function Studies Show an AST of 90 and an ALT of 85—Both Are Declining. MRCP Did Not Demonstrate Any CBD Stones or Ductal Dilation. Is an ERCP Indicated?
Stuart Sherman, MD |
| Question 28. | What Is the Best Approach to a Patient with a Post Lap Cholecystectomy Bile Leak from the Cystic Duct Stump, Aberrant Ducts, or Associated Common Duct Injury? If Initial Stenting Fails to Seal the Leak, What Else can Be Done Endoscopically?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Question 29. | What Should My Response Be to a Surgeon Who Demands that I Do Prelaparoscopic Cholecystectomy ERCP on All of His Gallstone Patients?
John Lee |
| Question 30. | What Should Be The Sequence of Investigations for a Patient with Recurrent, Unexplained Pancreatitis?
Stuart Sherman, MD |
| Question 31. | I Have a Patient with Biliary-Type Pain but No Other Evidence of Bile Duct Disease (Normal Diameter Duct on Ultrasound, Normal Liver Function Tests). How Should Such a Patient Be Managed?
Martin L. Freeman, MD |
| Question 32. | How Can We Accurately Determine the Appropriate Length of the Stent to Use in a Patient with a Bile Duct Stricture?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE, and Erina Foster, MD |
| Question 33. | I Have Difficulty Controlling the Direction of a Biliary Papillotomy. Any Tricks to Improve the Results?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE, and Erina Foster, MD |
| Question 34. | Whenever I Place a Stent for a Stone Impacted Bile Duct or for Bile Leak, the Stent Always Seem to Shift Position Distally, Should I Use a Shorter Stent or a Pigtail Stent? Is There a Trick to Keep These Stents in Place?
Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Section IV. | EUS |
| Question 35. | Do All Pancreatic Cysts Need EUS Imaging, and Do They All Need to Be Aspirated for Analysis? Are There Even Standard Criterion to Determine Their Origins?
Christopher J. DiMaio, MD, and William R. Brugge, MD |
| Question 36. | I Am Frustrated by Our Endosonographer Who Frequently Detects Vague Hypoechoic Pancreatic Lesions, but Does Not Perform Fine Needle Aspiration. He Always Recommends Follow-Up EUS in 3 Months. How Often and How Many Follow-Up Examinations Are Needed? Is It Unsafe to Do FNA of the Pancreas?
Kenneth J. Chang, MD |
| Question 37. | When Is EUS Necessary for a Newly Diagnosed Cancer of the Esophagus, Stomach, Colon, or Pancreas?
Thomas J. Savides, MD |
| Section V. | Capsule Endoscopy |
| Question 38. | How Do I Manage a Middle-Aged Woman with an Asymptomatic 5-cm Fluid-Filled Cyst in the Tail of the Pancreas, Found Incidentally on Abdominal CT Scanning?
Niraj Ajmere, MD, and David Cave, MD, PhD |
| Question 39. | In True Obscure GI Bleeding, What Should I Do if a Capsule Endoscopy and Upper and Lower Endoscopies Are Unrevealing?
Niraj Ajmere, MD, and David Cave, MD, PhD |
| Question 40. | What Are the Features that Differentiate a Submucosal Bulge from a True Mass on Capsule Endoscopy? What Can I Do to Confirm a Submucosal Mass?
Blair Lewis |
| Question 41. | What Is a Reliable Method to Estimate the Location of a Lesion Found on Capsule Endoscopy? What Is Your Approach if You Suspect a Submucosal Mass but Not Certain Where That Is in the Small Intestine?
Lucinda A. Harris, MD, and Jonathan A. Leighton, MD |
| Question 42. | When Should I Look for Possible Retained Endoscopic Capsules? What Should I Do When That Happens?
Lucinda A. Harris, MD, and Jonathan A. Leighton, MD |
| Section VI. | Miscellaneous |
| Question 43. | If I Suspect a Small Bowel Lesion, How Do I Choose Among Small Bowel Series, Capsule Endoscopy, CT Enterography and Double Balloon Enteroscopy as the Diagnostic Test?
Hendrikus S. Vanderveldt, MD, MBA, and Jamie S. Barkin, MD, FACP, MACG, AGAF, FASGE |
| Question 44. | What Is the Proper Way of Performing an Intraoperative Enteroscopy and When Should It Be Done in Place of the Other Nonoperative Ways of Examining the Small Intestine?
Blair Lewis |
| Question 45. | What Can an Endoscopist Do to Evaluate Upper Abdominal Pain in Patients Who Have Undergone Gastric Bypass Surgery for Obesity?
Lynne Do, MD, and Joseph Leung, MD, FRCP, FACP, FACG, FASGE |
| Question 46. | What Are the Proven Successful Endoscopic Methods in Treating Gastrointestinal Fistula?
Fauze Maluf Filho, MD, and Paulo Sakai |
| Question 47. | Bougienage, Balloon Dilation, Cautery Cutting, Stenting and Steroid Injection Have All Been Described to Treat Benign Strictures. Is There a Right Way of Doing This?
David Carr-Locke |
| Question 48. | Less and Less Sigmoidoscopies Are Being Performed. Should We Even Bother Doing Them?
Tom Zarchy, MD, and Francis A. Farraye, MD, MSc |
| Question 49. | When Should I Perform a Push Enteroscopy and Are an Overtube and Fluoroscopy Necessary for the Procedure?
Christopher J. Gostout, MD |
| Index | |