image of the week

Welcome to our image of the week!

Every week we present an endoscopic picture - click on the image for the diagnosis.

28. January 2020

CIRS

diagnosis


24. September 2019

duodenum

diagnosis

Endosonographic image of a duodenal diverticulum using watre filling


17. September 2019

diagnosis

Small pedunculated sigmoid adenoma (low grade); the distorted pattern at the polyp tip does not indicate more severe histopathology


10. September 2019

esophagus

diagnosis

Close-up image of a Barrett carcinoma on NBI only visible with a cap


3. September 2019

diagnosis

Endosonographic visualization of a distal bile duct carcinoma with echopoor and irregular wall thickening and a small part of the bile duct lumen


27. August 2019

gastric

diagnosis

See image of last week – visualization with cap and acetic acid staining – typical Barrett epithelium


20. August 2019

gastric

diagnosis

Image of the cardia with questionable small Barrett island – see image next week


13. August 2019

gastric

diagnosis

Reddish fundic gland polyp in the stomach (histologically confirmed)


6. August 2019

colon

diagnosis

Slightly prominent appendiceal orifice in cecum


30. July 2019

esophagus

diagnosis

Distal esophagus in a patient with longstanding achalasia showing erosive changes, probably due to stasis


23. July 2019

colon

diagnosis

Valley Sign of a colon adenoma, first described by Dr. Rex in 2017


16. July 2019

colon

diagnosis

Tubullovillous adenoma.


9. July 2019

colon

diagnosis

BLI highlights the mucosal surface and vascular pattern morphology. In combination with an optical zoom, in vivo diagnosis of a tubular adenoma can be easily achieved


2. July 2019

esophagus

diagnosis

Carcinoma in a short-segment Barrett’s esophagus


25. June 2019

esophagus

diagnosis

Submucosal tunnel during a POEM procedure.


18. June 2019

colon

diagnosis

Post-inflammatory polyps in ulcerative colitis imaged with LCI. Identification of dysplasia in those cases can become extremely challenging.


11. June 2019

colon

diagnosis

NET of the rectum imaged with BLI. Although small, the lesion can be clearly demarked for subsequent endoscopic resection.


4. June 2019

colon

diagnosis

Invasive amebiasis in the colon, with ulcerations in the right colon.


28. May 2019

colon

diagnosis

Multiple vessels after polypectomy. Not that endoscopic clipping is not always necessary.


21. May 2019

esophagus

diagnosis

Mucomyotomy of Zenker’s diverticulum. Muscle fibers are already clearly exposed.


14. May 2019

gastric

diagnosis

Gastric cancer imaged with BLI for visualization of the mucosal surface and vascular pattern network. Endoscopic resection (ESD) was performed for the lesions.


7. May 2019

esophagus

diagnosis

Long segment Barrett’s esophagus imaged with LCI.


30. April 2019

gastric

diagnosis

Small early gastric cancer visualized with LCI. The so called “red-in-purple” sign is always suspicious for neoplasia.


23. April 2019

colon

diagnosis

Inflammatory colon polyps are common. As identification of dysplasia in those lesions is difficult, endoscopic resection should be performed.


16. April 2019

colon

diagnosis

BLI highlights the mucosal surface and vascular pattern morphology. In combination with an optical zoom of 135-fold, optical diagnosis of a tubular adenoma can be easily achieved.


9. April 2019

colon

diagnosis

Endoscopic full thickness resection with the FTRD system. Duplication of the single layers is clearly visible.


2. April 2019

esophagus

diagnosis

Barrett’s cancer imaged with Linked Color Imaging (LCI) which strongly highlights the neoplastic tissue.


26. March 2019

duodenum

diagnosis

Large duodenal lipoma


12. March 2019

esophagus

diagnosis

Submucosal bulge in the esophagus, collapsing (right) suggesting esophageal duclication. Confirmation by endosonography showing mucosal structure in the wall of the duplication (below).


5. March 2019

duodenum

diagnosis

Duodenum in Graft versus Host Disease (GvHD)


19. February 2019

esophagus

diagnosis

Food residues in a smaller Zenker diverticulum


12. February 2019

duodenum

diagnosis

Duodenal varices


5. February 2019

esophagus

diagnosis

Recurrent Zenker diverticulum, scarring and deviating


15. January 2019

duodenum

diagnosis

Healed duodenal ulcer without fibrin


8. January 2019

esophagus

diagnosis

Small Zenker diverticulum (1 cm on barium swallow), hardly visible on endoscopy beside a hypertrophic upper sphincter


25. December 2018

duodenum

diagnosis

Healing duodenal ulcer with elevated margin at the upper duodenal curve


11. December 2018

gastric

diagnosis

Linitis plastica (diffusely infltrating gastric cancer)


4. December 2018

duodenum

diagnosis

Duodenal bulb ulcer


27. November 2018

esophagus

diagnosis

Epiphrenic diverticulum in the distal esophagus


20. November 2018

gastric

diagnosis

Early gastric cancer at the angular fold (incisura angularis)


13. November 2018

ERCP

diagnosis

Patient with a known ulcerative colitis and elevated liver enzyms - ERCP with typical aspect of a PSC


6. November 2018

esophagus

diagnosis

Barrett esophagus after forceps biopsies, simulating erosions or neoplasia


2. October 2018

Bile ducts

diagnosis

Patient with a large common bile duct stone


25. September 2018

duodenum

diagnosis

Duodenal diverticulum


18. September 2018

esophagus

diagnosis

Flat erosive Barrett cancer (AEG cancer type I, AEG=adenocarcinoma of esophagogastric junction)


11. September 2018

esophagus

diagnosis

Classic long-segment Barrett esophagus


4. September 2018

colon

diagnosis

Capsule endoscopy in a patient with "Blue rubber bleb naevus Syndrom", showing a venous ectasia in the jejunum


28. August 2018

gastric

diagnosis

Two angiodysplastic lesions at the gastric incisura (angular fold)


21. August 2018

colon

diagnosis

Patient with a pseudomembranous colitis (Clostridium difficile)


14. August 2018

esophagus

diagnosis

Barrett esophagus with prominent vessels in a patient with portal hypertension


7. August 2018

gastric

diagnosis

Multifocal areas of intestinal metaplasia (NBI imaging)


31. July 2018

duodenum

diagnosis

Small flat duodenal adenoma in the descending duodenum


24. July 2018

colon

diagnosis

Patient with Crohn's disease and fistulation from sigmoid colon to descending colon


17. July 2018

esophagus

diagnosis

Known Barrett esophagus with 2 small neoplastic lesions, on histology metastases of breast cancer


10. July 2018

gastric

diagnosis

Fibrinous gastric erosions (NSAID)


3. July 2018

duodenum

diagnosis

Flat duodenal adenoma at the distal end of the bulb


26. June 2018

esophagus

diagnosis

Barrett mucosa in near focus and with acetic acid staining with central high-grade dysplastic lesion


19. June 2018

papilla

diagnosis

Pedunculated ampullary adenoma


5. June 2018

gastric

diagnosis

Polypoid gastric erosions


15. May 2018

esophagus

diagnosis

Esophagus in advanced achalasia showing chronically inflamed and thickened mucosa and a distal ulcer due to pressure necrosis by obstructing food


1. May 2018

gastric

diagnosis

Hämorrhagic gastric erosions


24. April 2018

duodenum

diagnosis

Duodenal involvement in Crohn´s disease


10. April 2018

esophagus

diagnosis

Esophagus in achalasia showing muscular rings and prominent veins


3. April 2018

papilla

diagnosis

Perforation after endoscopic sphincterotomy


27. March 2018

gastric

diagnosis

Gastric erosion with biopsy positive for cancer, but ESD specimen negative („biopsy cancer“)


20. March 2018

duodenum

diagnosis

Duodenal bulb with gastric metaplasia (magnification endoscopy)


6. March 2018

esophagus

diagnosis

Distal esophagus in achalasia; muscular spasm leads to overvisualization of submucosal vessels


27. February 2018

papilla

diagnosis

Swollen und reddened papille with massive pus evaculation


20. February 2018

gastric

diagnosis

Atrophic gastritis in the gastric fundus with vascular pattern


13. February 2018

duodenum

diagnosis

Duodenal bulb with reddisch gastric metaplasia


6. February 2018

esophagus

diagnosis

Boerhave syndrome with deep defect.


30. January 2018

papilla

diagnosis

Papilla in a patient with Billroth II anatomy and pus


23. January 2018

gastric

diagnosis

Atrophic gastritis with small neuroendocrine tumor


15. January 2018

duodenum

diagnosis

Duodenal mucosa with 3 small metastases of breats cancer (histologically confirmed)


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