iGIE最新文献

{"title":"Submucosal injection–related foreign body reaction complicating endoscopic submucosal dissection: this time, it is not the usual suspect","authors":"Fouad Jaber MD, MS, Rollin George MD, Roshan Raza MD, Salmaan Jawaid MD","doi":"10.1016/j.igie.2026.02.007","DOIUrl":"10.1016/j.igie.2026.02.007","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 386-387"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Case series of hemostatic outcomes of defect closure using a novel anchor-pronged clip after gastric endoscopic submucosal dissection","authors":"Kenichiro Okimoto MD, PhD,&nbsp;Tomoaki Matsumura MD, PhD,&nbsp;Shohei Mukai MD,&nbsp;Tsubasa Ishikawa MD, PhD,&nbsp;Akane Kurosugi MD, PhD,&nbsp;Michiko Sonoda MD, PhD,&nbsp;Tatsuya Kaneko MD, PhD,&nbsp;Yuki Ohta MD, PhD,&nbsp;Takashi Taida MD, PhD,&nbsp;Keisuke Matsusaka MD, PhD,&nbsp;Jun-ichiro Ikeda MD, PhD,&nbsp;Jun Kato MD, PhD","doi":"10.1016/j.igie.2025.10.012","DOIUrl":"10.1016/j.igie.2025.10.012","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Delayed bleeding (DB), occurring in 4.1% to 8.5% of gastric endoscopic submucosal dissection (ESD) cases, is one of the most common adverse events. The aim of this study was to evaluate whether defect closure using the novel anchor-pronged clip after gastric ESD contributes to the prevention of DB.</div></div><div><h3>Methods</h3><div>A retrospective study at Chiba University Hospital (Chiba, Japan) included consecutive patients who underwent gastric ESD (August 2023–August 2024). The primary outcome was the rate of DB in the effective closure group, whereas the secondary outcomes included the effective closure rate and the full closure rate. Effective closure (≥50% of defect area) rate was defined as the proportion of study cases among all 127 cases. Full closure (≥90% of defect area) rate was defined as the proportion of study lesions among all 145 lesions during the period. The operators attempted to perform closure with the novel anchor-pronged clip for all cases. Among these, cases with effective closure were mainly analyzed. The first clip placed for defect closure was the novel anchor-pronged clip to achieve mucosa-to-mucosa or mucosa-to-muscle-layer closure. Additional clips could be either the same anchor-pronged clip or other typical through-the-scope clips. Clinical outcomes and adverse events including DB was calculated.</div></div><div><h3>Results</h3><div>Out of 127 cases and 145 lesions, 111 cases and 124 lesions were included in the main analysis. The DB rate was 1.8%. The median diameters (interquartile range) (mm) of the macroscopic lesion and resected specimen were 10 (9-15) and 30 (25-35), respectively. The median closure time per lesion was 9 minutes. The effective closure and the full closure rate was 87.4% and 80.0%, respectively.</div></div><div><h3>Conclusions</h3><div>Defect closure with the novel anchor-pronged clip after gastric ESD was associated with a high effective closure rate and a low DB rate (1.8%), suggesting that this method may help reduce the risk of DB.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 283-290"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078576","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ciliated foregut cyst of the pancreas: a rare mimic of intraductal papillary mucinous neoplasm","authors":"Raquel Gonçalves MD,&nbsp;Pedro Moutinho-Ribeiro MD, PhD,&nbsp;Ana Marques MD,&nbsp;Joanne Lopes MD,&nbsp;Guilherme Macedo MD, PhD","doi":"10.1016/j.igie.2025.12.003","DOIUrl":"10.1016/j.igie.2025.12.003","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 367-369"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078697","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Knife-assisted endoscopic full-thickness resection of deeply invasive esophageal adenocarcinoma: a case series","authors":"Pieter Jan Poortmans MD,&nbsp;Maria Eva Argenziano MD,&nbsp;Michele Montori MD,&nbsp;Andrea Sorge MD,&nbsp;Lynn Debels MD,&nbsp;Lobke Desomer MD,&nbsp;David James Tate MBBS, MA (Cantab), PhD","doi":"10.1016/j.igie.2025.12.008","DOIUrl":"10.1016/j.igie.2025.12.008","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophageal adenocarcinoma (EAC) incidence is rising globally, and current therapeutic options carry substantial morbidity and mortality. We report the feasibility and early outcomes of knife-assisted endoscopic full-thickness resection (kFTR) as a palliative local control in nonsurgical candidates.</div></div><div><h3>Methods</h3><div>Three patients with suspected locally advanced distal EAC (clinical tumor stage T1b-T2), no nodal or distant disease, and high Charlson Comorbidity Index scores were unfit for surgery and declined chemoradiotherapy. All consented to kFTR: a submucosal pocket was created cranial to the suspected invasive area, the muscle-retracting sign was identified, and the muscularis propria was incised to access the periesophageal space. The lesion was dissected laterally and resected en bloc. A fully covered metal stent was then placed.</div></div><div><h3>Results</h3><div>Patients resumed oral intake on day 5 without major adverse events. All had EAC pathologic tumor stage 1b with invasion into the deepest layer of the submucosa; 2 had positive vertical margins. One remained disease-free (24 months); 2 had local recurrence by 6 months but remained asymptomatic at last follow-up (10 and 14 months).</div></div><div><h3>Conclusions</h3><div>In carefully selected symptomatic, inoperable patients, kFTR achieved short-to-medium term symptom control for locally advanced EAC with acceptable safety.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 433-439"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Efficacy and safety of a novel technique using endoscopic ultrasound—guided fine-needle injection of botulinum toxin and balloon dilation in achalasia","authors":"Aqsa Khan MD,&nbsp;Harishankar Gopakumar MD,&nbsp;Ricardo J. Marrero Torres MD,&nbsp;Ahmad Abulawi MD,&nbsp;Talia Malik MD,&nbsp;Dushyant Singh Dahiya MD,&nbsp;Mariajose Rojas DeLeon MD,&nbsp;Amelia Roebuck PhD,&nbsp;Neil R. Sharma MD","doi":"10.1016/j.igie.2025.10.014","DOIUrl":"10.1016/j.igie.2025.10.014","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Achalasia is an esophageal motility disorder characterized by the inability of the lower esophageal sphincter to relax. Endoscopic methods are currently the mainstay treatment of achalasia and include local administration of botulinum toxin (Botox; Allergan Aesthetics, Westport, Ireland), pneumatic dilation, and peroral endoscopic myotomy. Botox injections traditionally have been performed by standard endoscopy, which lacks precision requiring frequent interventions. Our study introduces a novel technique using endoscopic ultrasound—guided fine-needle injection of Botox combined with controlled radial expansion balloon dilation (EUS-BTID) for treating achalasia. We hypothesize that this combined approach will enhance the efficacy and offer a favorable safety profile compared with standard endoscopic Botox injection.</div></div><div><h3>Methods</h3><div>We conducted a single-center retrospective study to evaluate the efficacy and safety of a novel technique using EUS-BTID to treat achalasia using electronic medical records.</div></div><div><h3>Results</h3><div>Our study included a total of 43 patients, with a mean age of 76 years (standard deviation 14 years). The most frequent achalasia subtype was type II (46%). Among 16 patients (37.2%) who underwent multiple sessions of EUS-BTID, the number of sessions ranged from 2 to 14, with the 14-session maximum occurring in a single patient. The average interval between repeat procedures across all patients was 273 days. The primary outcome of improved dysphagia scores, measured by the Eckardt score, was observed in 86.7% of patients, with 70.0% achieving scores indicative of complete remission. After EUS-BTID, the median Eckhardt score significantly improved from 6 (interquartile range, 4-7) to 2 (interquartile range, 1-4) (<em>P</em> &lt; .0001). No serious adverse events were reported; only 2 patients (4.6%) experienced mild transient postprocedural symptoms, including chest discomfort and emesis.</div></div><div><h3>Conclusion</h3><div>The novel EUS-BTID technique appears to be an effective and safe treatment option for achalasia. The combination of endoscopic ultrasound—guided Botox injection and balloon dilation offers significant improvements in symptom relief with a favorable safety profile and durability and can be applied in high-risk patients or probably as a bridge to more definitive therapy. Although our study provides encouraging evidence supporting the use of EUS-BTID, further research is required to validate these findings.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 325-330"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078690","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Arterial blood flow detection and clinical outcomes of patients with flat spots and diverticular hemorrhage","authors":"Peerapol Wangrattanapranee MD,&nbsp;Dennis M. Jensen MD,&nbsp;Mary Ellen Jensen MLS,&nbsp;Gail Thibodeau DVM","doi":"10.1016/j.igie.2025.10.015","DOIUrl":"10.1016/j.igie.2025.10.015","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Colonoscopic hemostasis is recommended for diverticular (TIC) hemorrhage (TICH) with major stigmata of recent hemorrhage (SRH). Whether flat spots should be included as a major SRH is unknown. For TIC flat spots, our aims were (1) to report rates of blood flow detected underneath by Doppler endoscopic probe (DEP), (2) to compare rebleeding rates of medical versus endoscopic treatment, and (3) to compare rates of arterial blood flow detection and rebleeding with nonbleeding visible vessels (NBVVs).</div></div><div><h3>Methods</h3><div>This is a retrospective study of prospectively collected data of patients at West Los Angeles Veterans Affairs and Ronald Reagan University of California, Los Angeles Medical Centers (Los Angeles, Calif, USA) from 1993 to 2023 for definitive TICH from either flat spots or NBVVs. Arterial blood flow underneath SRH was monitored by DEP. Descriptive and comparative analyses were used.</div></div><div><h3>Results</h3><div>Of 24 patients with TIC flat spots, treatment in 83.3% was hemostatic clips versus 16.7% medical. Seventeen of 19 patients with DEP monitoring had positive arterial blood flow, and all had hemostatic clipping. Within 30 days, 25% of the medical group rebled, whereas 10% of the endoscopic group rebled. After 30 days, 35% of the endoscopic group rebled versus none of the medical group. Rates of positive DEP were the same for flat spots and NBVVs. Flat spot patients had a significantly lower rate of colonoscopic hemostasis and a higher rebleeding rate.</div></div><div><h3>Conclusions</h3><div>TIC flat spots should be considered as a major SRH and treated because of high rates of arterial blood flow underneath and rebleeding. Improvements in TICH spot hemostasis are warranted.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 331-339"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078691","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel mechanical debridement technique to assist in removal of deeply embedded degenerated esophageal metal stent: a case report","authors":"Biswa Ranjan Patra MD, DM,&nbsp;Nitish Patwardhan MD, DM,&nbsp;Vaibhav Padole MD,&nbsp;Souradeep Pal MD,&nbsp;Yash Harwani MD,&nbsp;Sidharth Harindranath MD, DM,&nbsp;Akash Shukla MD, DM","doi":"10.1016/j.igie.2025.12.004","DOIUrl":"10.1016/j.igie.2025.12.004","url":null,"abstract":"<div><div>Embedment of a self-expandable metal stent (SEMS) is a rare but serious adverse event, often due to granulation tissue overgrowth, with prolonged dwell time being a major risk factor. An 18-year-old girl with a history of corrosive esophageal stricture and SEMS placement 26 months earlier presented with progressive dysphagia. Endoscopy revealed a completely embedded stent with distal stenosis. Initial management with stent-in-stent technique using fully covered SEMSs and argon plasma coagulation (APC) failed to achieve tissue necrosis. Mechanical debridement was, therefore, undertaken using a novel approach with standard endoscopic accessories, given the unavailability of specialized devices. Circumferential APC was followed by superficial tissue scraping with biopsy forceps and deeper debridement with a distal attachment cap. After 2 sessions, the stent was fully exposed and removed safely. This case highlights that mechanical debridement with routine endoscopic tools can provide a safe, effective, and accessible solution for deeply embedded esophageal stents.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 411-415"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078756","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Application of a conical transparent cap for the retrieval of extraluminal foreign bodies","authors":"Jia-Huan Liu MD,&nbsp;Bin-Yang Luo MM,&nbsp;Zhu Wang MD","doi":"10.1016/j.igie.2025.07.009","DOIUrl":"10.1016/j.igie.2025.07.009","url":null,"abstract":"","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 363-364"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Safety of delaying endoscopic intervention for complete esophageal soft food bolus impaction","authors":"Thomas Hoang MD,&nbsp;Andrew Fetz MD, FRCPC,&nbsp;Ranjit Andrew Singh MD, FRCPC","doi":"10.1016/j.igie.2026.01.004","DOIUrl":"10.1016/j.igie.2026.01.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophageal soft food bolus obstruction is a common emergency department presentation that requires urgent endoscopic intervention. Although current guidelines recommend intervention within 6 to 12 hours, recent evidence indicates that extending this timeframe has not been associated with worsening clinical outcomes. We aim to investigate the safety of delaying endoscopy beyond 6 hours of triage for complete esophageal food bolus obstructions.</div></div><div><h3>Methods</h3><div>We conducted a multicenter retrospective cohort study evaluating coprimary outcomes of 30-day mortality and dysphagia-related hospitalizations and secondary outcomes of procedural adverse events among patients who underwent early (within 6 hours of triage) and delayed (after 6 hours of triage) endoscopic management of those with triage symptoms consistent with a complete esophageal food bolus impaction.</div></div><div><h3>Results</h3><div>Mortality was not observed in either the early or delayed cohorts, and there was no difference in rehospitalization (4.4% vs 3.3%, respectively; <em>P</em> = 1). There was a numerical difference in mucosal injury (2.2% vs 13.2%) that was not statistically significant (<em>P</em> = .15). Similar rates of general anesthesia (6.67% vs 6.67%; <em>P</em> = 1) were observed in both cohorts. Patients with delayed management were less likely to have a food bolus visualized (86.7% vs 63.3%; <em>P</em> = .025) and thus less likely to require endoscopic instrumentation. Accessory use was 24.4% and 20% (<em>P</em> = .781) in the early and delayed cohorts, respectively. Multivariable analysis showed no correlation among clinical demographics, presence of eosinophilic esophagitis, or procedural time with mucosal injury. Endoscopic instrumentation was associated with increased but not statistically significant odds of mucosal injury (odds ratio, 5.0; 95% confidence interval, 0.443-58.1; <em>P</em> = .192).</div></div><div><h3>Conclusions</h3><div>Delaying endoscopic intervention beyond 6 hours of presentation does not result in significantly worse clinical outcomes. These results will help endoscopists risk stratify food bolus cases, possibly delaying intervention until daytime hours when more endoscopy personnel and resources are available.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 357-362.e1"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078694","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Endoscopic management of colocolonic anastomotic dehiscence: a case report","authors":"Inês Rodrigues Simão MD,&nbsp;Rui Mendo MD,&nbsp;Pedro C. Figueiredo MD","doi":"10.1016/j.igie.2026.02.013","DOIUrl":"10.1016/j.igie.2026.02.013","url":null,"abstract":"<div><div>We describe the case of a woman who developed a perianastomotic collection after colocolonic anastomosis for restoration of bowel continuity, consistent with an anastomotic dehiscence. Endoscopy revealed a stenotic anastomosis inaccessible to vacuum therapy. A fully endoscopic strategy was pursued, combining internal drainage of the collection with double-pigtail stents and treatment of the stenosis through balloon dilation. The patient showed a favorable course, with complete resolution on follow-up. This case underscores the feasibility, safety, and efficacy of endoscopic management of colocolonic anastomotic dehiscence, highlighting the importance of simultaneously addressing associated stenosis.</div></div>","PeriodicalId":100652,"journal":{"name":"iGIE","volume":"5 3","pages":"Pages 420-423"},"PeriodicalIF":0.0,"publicationDate":"2026-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149078703","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}