🇨🇴 Just sayin'. MD, UNAB. Internal Medicine, UdeA. Gastroenterology, U-CES Special interest in Interventional Endoscopy 📺Gastrobacter (Youtube)
Medellín, Colombia
Joined July 2017
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A cervical inlet patch is an area of heterotopic gastric mucosa in the proximal esophagus found on upper endoscopy that may secrete acid, mucus, or pepsin.
CIP can be associated with LPS and globus and ablation of inlet patch has been shown to reduce LPS in small case series
Algorithm for Laryngopharyngeal Symptoms !
LPS include cough, voice hoarseness/change, throat clearing, excess phlegm in the throat, and throat pain/sore throat.
When Should a GI Consider the Diagnosis of Scleroderma?
• IEM or absent contractility + ↓ esophageal sphincter hypotension
• Recurrent esophageal candidiasis (immunocompetent)
• Progressive and/or severe reflux not responding to PPIs
Raynaud’s + puffy/thick fingers + ANA (+) + dysphagia/reflux = think SSc.
Raynaud’s is present in 90–95% of SSc patients and is often the first sign.
Quality indicators for colonoscopy and their associated performance target and strength of recommendation
Beautiful cecal patch
Periappendiceal inflammation is more severe than distal proctitis: (A) normal TI (B) inflammation at the cecal base with erythema, erosions, and mucopurulent exudates. (C) Normal ascending colon. (D) Distal 10 cm rectum with mild erythema on retroflex view.
Recurrent dysphagia following POEM or LHM:
-incomplete myotomy
-anatomic complications related to intervention
(blown-out myotomy, fundoplication-related)
-postoperative esophageal motility abnormalities
-anatomical distortions of the esophageal body
-GERD-related complications
Pearl #3
Consider screening upper endoscopy in patients with a first-degree family history of gastric cancer or persistent H. pylori infection that could not be eradicated. In these higher-risk groups, endoscopic surveillance every 3–5 years should be considered.
J. Sebastián P. A. retweeted
How to select esophageal stents?
Esophagus is 25 mm × 25 cm tube.
Diameter:
•16–18 mm→strictures/anastomoses, but ↑migration
•23 mm→leaks, fistulas, strictures; ↑discomfort, perforation
Length: 10, 12, 15 cm
•Extend ≥2 cm beyond stricture
•GEJ involved: Long stents
Pearl 2. Before labeling acute pancreatitis as idiopathic, consider EUS
It has >90% sensitivity and specificity for detecting microlithiasis, biliary sludge, and small pancreatobiliary or periampullary lesions.
EUS should be performed 4–6 weeks after the acute episode.
Pearl #1.
Do not assume that every GI bleed in a patient taking anticoagulants is caused by the anticoagulant itself. GI bleed that occurs soon (first 6–12 months) or that persists (>7 days) should prompt evaluation for an underlying gastrointestinal malignancy.
