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Upper GI tract

Upper GI tract

Endoscopic techniques | Instruments | Teaching videos | Upper GI tract

Endoscopic removal of a buried bumper using the Flamingo system

A patient with an ingrown internal PEG retaining plate (buried bumper syndrome) on the anterior wall of the gastric body. Endoscopic removal of the device

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Galleries | Upper GI tract

Stomach: Light Blue Crest Sign for Intestinal Metaplasia

Gastric Intestinal Metaplasia is a risk factor of intestinal-type gastric cancer, but WLI was not adequate to detect IM of stomach. NBI system with and

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Classifications | Upper GI tract

BING Classification Early Barrett Neoplasia

Multimodal therapy for early Barrett’s neoplasias, has become established as the standard therapy and is set out in national and international guidelines. These dysplastic lesions

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Classifications | Upper GI tract

Achalasia: Chicago Classification

Achalasia is one of the differential diagnoses in patients with symptoms of dysphagia. High-resolution (HR) manometry is now regarded as the diagnostic gold standard for

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Classifications | Upper GI tract

Paris Classification: Early Barrett Cancers

In the following, examples for superficial/early Barrett lesions of the esophagus are shown. Here, flat and sessilelesions are predominant, pedunculated tumors are rare. Sessile tumor

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Teaching videos | Upper GI tract

The bougie cap – a new method of treating stenoses in the gastrointestinal tract

In the classic method, a stricture in the esophagus is dilated using a Savary bougie after advancement of a guide wire. The difficulty with this

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Classifications | Upper GI tract

Esophagastric Junction Cancers (AEG)

Tumors of the esophagogastric junction should be classified not only according to the TNM system with regards to tumor penetration (T stage), presence of lymph

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ERCP | Teaching videos | Upper GI tract

Roux-en-Y anatomy after gastric resection

This video illustrates the altered anatomy resulting after the type of gastric resection that is carried out for gastric carcinoma, for example. Bowel continuity is

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Special Cases | Teaching videos | Upper GI tract

Endoscopic full-thickness resection of a GIST using GERD-X

A subepithelial tumor has been identified in the fundus. EUS shows that it is 2.5 × 3 cm in size, probably arising from the muscularis propria. No pathological

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ERCP | Teaching videos | Upper GI tract

Billroth II anatomy after partial stomach resection

This video explains the altered anatomy that is encountered after a Billroth II operation. In a Billroth II resection, the lower part of the stomach

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Classifications | Lower GI tract | Upper GI tract

Paris Classification Early Cancer

Endoscopic treatment for early carcinoma in the gastrointestinal tract has in the meantime become evidence-based and has been incorporated into national and international guidelines

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Classifications | Upper GI tract

Paris Classification: Early Squamous Cell Cancers Esophagus

Examples of superficial/early squamous cell lesions in the esophagus are presented below. In the esophagus, flat lesions are predominant in the early tumors, and polypoid

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Classifications | Upper GI tract

Paris Classification: Early Gastric Cancer

Examples of superficial/early gastric tumors are shown below. In the stomach, flat lesions are predominant, often as combined lesions with a central depression (IIa+c). Sessile

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Endoscopic techniques | Special Cases | Teaching videos | Upper GI tract

Gastric peroral endoscopic myotomy (G-POEM)

Hendrik Manner from Wiesbaden reports on a patient with a gastric emptying disorder who was treated with what is known as gastric peroral endoscopic myotomy

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Instruments | Special Cases | Teaching videos | Upper GI tract

The EndoRotor® as a completely new mechanical mucosectomy procedure — an alternative for faster ER and ESD?

Stephan Hollerbach and his team demonstrate an en-bloc resection in a swine model using the new mechanical EndoRotor® resection system.

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Endosonography | Teaching videos | Upper GI tract

Distal hypoechoic submucosal tumor in the esophagus

Submucosal lesions identified in the esophagus usually undergo further clarification using endoscopic ultrasonography (EUS). In this video, Thomas Rösch from Hamburg demonstrates the examination sequence

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Literature | Lower GI tract | Pancreas | Upper GI tract

News from DDW

The latest developments in the field of gastroenterology and endoscopy are presented every year at Digestive Diseases Week (DDW) in Chicago — although in recent

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Literature | Upper GI tract

Endoscopic Doppler examination and hemostasis in nonvariceal upper gastrointestinal hemorrhage: paradigm shift, or old wine in new bottles?

During hemostasis in patients with nonvariceal upper gastrointestinal hemorrhage, the Forrest classification is recommended for risk stratification, as it correlates best with the risk of

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Endoscopic techniques | Special Cases | Teaching videos | Upper GI tract

Tunnel removal of a submucosal tumor in the esophagus (SET technique)

Dr. Werner and Prof. Rösch from Hamburg present the case of a young patient with an incidental finding of esophageal GIST. In this patient, it

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Galleries | Upper GI tract

Endoscopic diagnosis of celiac disease

Celiac disease is a chronic inflammation trigged by the ingestion of gluten and resulting in a dense infiltration of lymphocytes in the proximal small intestine.

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Galleries | Upper GI tract

Neuroendocrine Gastric Tumors

Among the gastric submucosal tumors, neuroendocrine tumors are a special entity, which also require examination of independent gastric mucosal biopsies for classification.

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Galleries | Upper GI tract

When the Z-line is not completely normal

Depending on the patient’s degree of sedation and the examiner’s level of experience, carrying out a precise examination of the Z-line may not be very

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Classifications | Upper GI tract

Prague Classification Barrett Esophagus

The Prague classification was presented by an international research group in 2006 (1) and has since been regarded as the standard for measuring the length

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Classifications | Upper GI tract

Reflux Esophagitis: Los Angeles Classification

Gastroesophageal reflux disease with endoscopically identifiable lesions (erosions, stricture, Barrett’s esophagus) is defined as erosive gastroesophageal reflux disease (GERD). Fewer than 50% of patients with

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Classifications | Upper GI tract

Esophageal Varices

Various systems are available for classifying esophageal varices. Unfortunately, they only overlap or coincide partly. The official terminology used by the German Society for Digestive

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Classifications | Upper GI tract

Eosinophilic Esophagitis

A classification for eosinophilic esophagitis has not yet been included in the usual terminologies in the German-speaking countries. In the official terminology of the German

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Instruments | Teaching videos | Upper GI tract

Endoscopy antireflux therapy with the MUSE system

A 31-year-old female patient who has had reflux symptoms for 15 years and has responded well to PPI therapy. The patient wants to stop taking

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Pancreas | Special Cases | Teaching videos | Upper GI tract

Endoscopic therapy of pancreatic fluid collections caused by severe necrotic pancreatitis

Pancreatitis can cause various severe complications such as acute fluid collections with superinfected necrotic content requiring drainage and removal of necrotic debris. Here we demonstrate

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Literature | Upper GI tract

ESD probably no better than EMR in Barrett’s neoplasia

Considerable debate is currently taking place among therapeutic endoscopists regarding the best method of resecting early carcinomas, particularly in the upper gastrointestinal tract — whereas

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Endoscopic techniques | Special Cases | Teaching videos | Upper GI tract

Post-EMR arterial bleeding

Arterial bleeding from the area of the endoscopic mucosal resection, 2 days after the intervention. Successful hemostasis is achieved using bipolar coagulation forceps in “Soft

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Endoscopic techniques | Instruments | Teaching videos | Upper GI tract

PEXACT — direct-puncture PEG after gastropexy

The gastropexy device consists of two hollow needles that are attached to each other. A suture thread is inserted through one hollow needle, and a

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Endoscopic techniques | Teaching videos | Upper GI tract

Endoscopic division of a Zenker diverticulum using the Clutch Cutter

Endoscopic division of a Zenker diverticulum using the Clutch Cutter and management of a perforation. Coagulation of the diverticular septum using the Clutch Cutter. Settings:

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Special Cases | Teaching videos | Upper GI tract

Small carcinoma in Barrett’s esophagus — EMR and RFA

A 46-year-old patient with short-segment Barrett’s esophagus that had been receiving monitoring since 2009, now presenting with a mucosal adenocarcinoma.

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Endoscopic techniques | Teaching videos | Upper GI tract

Endoscopic examination of a normal Z-line

Visualization of the Z-line without enhancement and with iScan, obstructed by esophageal motility.

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Classifications | Upper GI tract

Fundic Varices

In contrast to esophageal varices, there is only one classification system for fundic varices, developed by Sarin et al.

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Literature | Upper GI tract

Risk stratification in Barrett’s esophagus — the emperor’s new clothes?

The efficacy of surveillance for Barrett’s patients is a matter of controversy, and it is probably due to the low long-term risk of carcinoma developing

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Literature | Upper GI tract

Low-grade dysplasia in Barrett’s esophagus — a second opinion is important, but then treatment is needed

Low-grade dysplasia (low-grade intraepithelial neoplasia, LGIN) is difficult to distinguish from inflammation histopathologically. The interobserver variance rates usually show kappa values below 0.4, representing a

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Literature | Upper GI tract

Does Barrett’s esophagus grow during monitoring?

The risk of progression of nonneoplastic Barrett’s esophagus to high-grade intraepithelial neoplasia or adenocarcinoma is extremely low and has been reported in recent studies to

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Literature | Upper GI tract

Achalasia — place of endoscopic therapy in the light of the first long-term data for POEM

Achalasia is a rare neuromuscular disease of unclear etiology that probably has a genetic background. The precise etiopathogenesis of achalasia is still unclear. Above all,

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