• Title/Summary/Keyword: Endoscopic ultrasound

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Endoscopic Management of Large Peripancreatic Fluid Collections in Two Pediatric Patients by Endoscopic Ultrasound-guided Transmural Drainage

  • Walsh, Leonard T.;Groff, Andrew;Mathew, Abraham;Moyer, Matthew T.
    • Pediatric Gastroenterology, Hepatology & Nutrition
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    • v.23 no.1
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    • pp.105-109
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    • 2020
  • The incidence of acute pancreatitis (AP) has increased in the pediatric population over the past few decades and it stands to follow that the complications of severe AP, including symptomatic pancreatic fluid collections (PFCs) will increase as well. In adults, the therapeutic options for this situation have undergone a dramatic evolution from mainly surgical approaches to less invasive endoscopic approaches, mainly endoscopic ultrasound-guided transmural drainage (EUS-TD) followed be direct endoscopic necrosectomy if needed. This has proven safe and effective in adults; however, this approach has not been well studied or reported in pediatric populations. Here we demonstrate that EUS-TD seems to offer a safe, efficacious and minimally invasive approach to the management of large PFCs in pediatric patients by reviewing two representative cases at our institution.

Role of Endoscopic Ultrasound in the Assessment of Superficial Esophageal Cancer (조기 식도암에서 내시경초음파의 역할)

  • Cho, Yu Kyung
    • Korean Journal of Bronchoesophagology
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    • v.17 no.1
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    • pp.19-22
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    • 2011
  • Endoscopic ultrasound in the diagnosis of esophageal carcinoma is an indispensable procedure, not only to discuss the preoperative staging of the lesion, but also to evaluate the therapeutic effect of chemo-radiation therapy. The recent increase in the incidence of superficial esophageal cancer and promising developments in potentially curative endoscopic therapies have placed EUS to a central position in decision making. Recent data have called into question the staging accuracy of EUS to distinguish mucosal from submucosal lesions, particularly in patients with early disease. In those cases, diagnostic endoscopic resection may be useful for staging and curative in superficial lesions. Nonetheless, EUS has been regarded as the most accurate staging tool and should be performed to identify potential candidates for endoscopic resection.

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Application of Endoscopic Ultrasound-based Artificial Intelligence in Diagnosis of Pancreatic Malignancies (악성 췌장 병변 진단에서 인공지능기술을 이용한 초음파내시경의 응용)

  • Jae Hee Ahn;Hwehoon Chung;Jae Keun Park
    • Journal of Digestive Cancer Research
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    • v.12 no.1
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    • pp.31-37
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    • 2024
  • Pancreatic cancer is a highly fatal malignancy with a 5-year survival rate of < 10%. Endoscopic ultrasound (EUS) is a useful noninvasive tool for differential diagnosis of pancreatic malignancy and treatment decision-making. However, the performance of EUS is suboptimal, and its accuracy for differentiating pancreatic malignancy has increased interest in the application of artificial intelligence (AI). Recent studies have reported that EUS-based AI models can facilitate early and more accurate diagnosis than other preexisting methods. This article provides a review of the literature on EUS-based AI studies of pancreatic malignancies.

Endoscopic Management of Gastric Subepithelial Tumor (위상피하종양의 내시경적 진단 및 치료)

  • Hyunchul Lim
    • Journal of Digestive Cancer Research
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    • v.10 no.1
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    • pp.16-21
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    • 2022
  • Diagnosis of gastric subepithelial tumors (SETs) is sometimes difficult with conventional endoscopy or tissue sampling with standard biopsy, so non-invasive imaging modalities such as endoscopic ultrasound (EUS) and computed tomography are used to evaluate the characteristics of SETs features (size, location, originating layer, echogenicity, shape). However imaging modalities alone is not able to distinguish among all types of SETs, so histology is the gold standard for obtaining the final diagnosis. For tissue sampling, mucosal cutting biopsy and mucosal incision-assisted biopsy and EUS-guided fine-needle aspiration or biopsy (EUS-FNA or EUS-FNB) is commonly recommended. Endoscopic mucosal resection (EMR) and endoscopic submucosal dissection (ESD) are used for resection of SETs involving the mucosal and superficial submucosal layers, could not treat adequately and safely the SETs involving the deep mucosa and muscularis propria. Submucosal tunneling endoscopic resection (STER) and endoscopic full-thickness resection (EFTR) is used as a therapeutic option for the treatment of SETs with the development of reliable endoscopic closure techniques and tools.

Minimally Invasive Approach to Esophageal Perforation after Endoscopic Ultrasound-Guided Fine-Needle Aspiration: A Report of 2 Cases

  • Geraedts, Anna C.M.;Broos, Pieter P.H.L.;Gronenschild, Michiel H.M.;Custers, Frank L.J.;Hulsewe, Karel W.E.;Vissers, Yvonne L.J.;de Loos, Erik R.
    • Journal of Chest Surgery
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    • v.53 no.5
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    • pp.313-316
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    • 2020
  • Esophageal perforation after endoscopic ultrasound-guided fine-needle aspiration for mediastinal staging is a rare but severe complication. We report 2 cases of patients with esophageal perforation who were treated using video-assisted thoracoscopic surgery in combination with esophageal stenting. Through these cases, the feasibility of minimally invasive thoracic surgery was evaluated.

Endoscopic Ultrasound Staging of Upper Gastrointestinal Malignancies

  • Saadany, Sherif El;Mayah, Wael;Kalla, Ferial El;Atta, Tawfik
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.5
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    • pp.2361-2367
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    • 2016
  • Since 1980, endoscopic ultrasound (EUS) has been used as an important tool for the evaluation of malignant diseases in hollow viscus and bilio-pancreas, as well as sub-epithelial tumors. The high-resolution capacity and low penetration depth of EUS make it possible to obtain highly detailed images of the gastrointestinal wall and immediate surroundings to a depth of 4-5 cm. Thus, over the past 35 years, EUS succeeded to modify management in significant number of cases and is now considered a gold standard tool for many gastrointestinal diseases, especially in the pancreatico-biliary tract, and adjuvant needle insertion now allows access to remote lesions that were difficult to reach in the past. With the growing spectrum of indications, tissue sampling for diagnostic purposes has become common. In this review, we aim to highlight the expanding spectrum of EUS indications and uses in staging of upper gastrointestinal malignancies, especially esophageal, gastric and ampullary tumors.

Pseudoaneurysm of Ulnar Artery after Endoscopic Carpal Tunnel Release

  • Ryu, Sung-Joo;Kim, In-Soo
    • Journal of Korean Neurosurgical Society
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    • v.48 no.4
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    • pp.380-382
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    • 2010
  • The authors present an extremely rare case of a pseudoaneurysm of the ulnar artery as a complication of a two-portal endoscopic carpal tunnel release (ECTR). A 70-year-old man with chronic renal failure and on maintenance hemodialysis with a left arteriovenous fistula presented with paresthesia of his right hand. A clinical diagnosis of right carpal tunnel syndrome was confirmed by ultrasonography and an electro physiologic study. He underwent two-portal ECTR, and the paresthesia was much improved. However, he presented to us one month after operation with severe pain, a tender mass distal to the right wrist crease and more aggravation of the paresthesia in the ulnar nerve distribution. Doppler ultrasound was performed and revealed a hypo echoic lesion 20 mm in diameter in the right palm, with arterial Doppler flow inside connected to the palmar segment of the ulnar artery. An ulnar artery pseudoaneurysm was diagnosed and treated by ultrasound-guided percutaneous thrombin injection. Transverse color Doppler ultrasound image showed complete thrombosis of the pseudoaneurysm and flow cessation after a total injection of 500 units of thrombin. The symptoms were also improved.

Case of Solitary Pancreatic Metastasis from Small Cell Lung Cancer

  • Park, Chul;Kim, Tae Hyeon;Yun, Ki Jung;Choi, Soon Ho;Lee, Sam Youn;Lee, Mi Kyung;Ryu, Dae Woong;Yang, Sei Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.26 no.6
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    • pp.980-982
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    • 2012
  • Metastasis to the pancreas from extra-pancreatic primary cancers are rare; they commonly present as a manifestation of widespread disease and rarely as an isolated mass of the pancreas. Examinations showed a pancreatic tumor infiltrating the pancreas tail portion and an endoscopic ultrasound guided percutaneous biopsy proved that the lesion was metastatic from the lung carcinoma. Most metastatic cases of the pancreas tend to be discovered in patients with widely disseminated malignant disease. In addition, patients with pancreatic metastasis are often asymptomatic, the metastatic lesions are found incidentally, and are misdiagnosed as primary pancreatic tumors. This report that patient undergoing chemotherapy for a small cell lung cancer, who 1 year and 3 months later, accidentally diagnosed of solitary pancreas metastasis and confirmed histology by needle biopsy using endoscopic ultrasound.

Clinical Application of $^{18}F-FDG$ PET in Esophageal Cancer (식도암에서의 $^{18}F-FDG$ PET의 임상 이용)

  • Choi, Joon-Young
    • Nuclear Medicine and Molecular Imaging
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    • v.42 no.sup1
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    • pp.32-38
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    • 2008
  • This review focuses on the clinical use of $^{18}F-FDG$ PET in esophageal cancer. For initial staging of esophageal cancer, $^{18}F-FDG$ PET is better than chest CT and is complementary to endoscopic ultrasound. Due to its good results for detecting distant metastasis, $^{18}F-FDG$ PET evades unnecessary curative surgery. Also, PET findings are associated with prognosis in esophageal cancer. $^{18}F-FDG$ PET seems to be useful for detecting recurrence and restaging in esophageal cancer. For therapy response assessment, $^{18}F-FDG$ PET is effective after chemotherapy or radiation therapy. $^{18}F-FDG$ PET is useful to predict pathological response after neoadjuvant therapy in esophageal cancer, which is better than chest CT and endoscopic ultrasound. For radiation therapy planning, $^{18}F-FDG$ PET may be helpful, but requires further investigations.