VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.005

Partha Pal MD, DNB, MRCP (UK), FASGE , Mohammad Abdul Mateen MD , Rajesh Gupta MD, DM , Manu Tandan MD, DM , D. Nageshwar Reddy MD, DM

{"title":"Hybrid endoscopic stricturotomy and balloon dilation of ascending colon stricture with cecal fecaliths in Crohn’s disease guided by preprocedural intestinal ultrasound","authors":"Partha Pal MD, DNB, MRCP (UK), FASGE , Mohammad Abdul Mateen MD , Rajesh Gupta MD, DM , Manu Tandan MD, DM , D. Nageshwar Reddy MD, DM","doi":"10.1016/j.vgie.2025.05.005","DOIUrl":"10.1016/j.vgie.2025.05.005","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Endotherapy for Crohn’s disease (CD) strictures has evolved as a minimally invasive alternative to surgery. Hybrid techniques combining endoscopic stricturotomy (ES) and balloon dilation (EBD) can improve outcomes. Intestinal ultrasound (IUS) has emerged as a point-of-care tool for stricture assessment. We present a case using preprocedural IUS-guided hybrid ES and EBD to manage an ascending colon stricture with proximal fecaliths in CD.</div></div><div><h3>Methods</h3><div>A 47-year-old man with ileocolonic CD (Montreal classification A2, L3, B2) receiving adalimumab and azathioprine presented with recurrent obstructive symptoms. IUS identified a short, predominantly fibrotic, ascending colon stricture. Earlier computed tomography enterography 6 months back ruled out additional strictures. On colonoscopy, ES was performed using an insulated-tip knife, followed by EBD up to 12 mm. Redundant mucosa was excised, and minor bleeding controlled. The stricture was successfully traversed, and fecaliths were extracted.</div></div><div><h3>Results</h3><div>The procedure was uneventful, and the patient was discharged the next day after adalimumab escalation. At 9-month follow-up, he remained symptom-free.</div></div><div><h3>Conclusions</h3><div>Hybrid ES and EBD guided by preprocedural IUS offer an effective multimodal approach for CD strictures, potentially delaying or avoiding surgery. Further studies are warranted to validate the long-term role of IUS in stricture management.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 540-543"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242402","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Pleural connection treated with stent plus endobronchial valve 胸膜连接用支架加支气管内瓣膜治疗

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.010

Mayank Goyal MBBS, Ashwariya Ohri MBBS, Preeyati Chopra MBBS, Khushboo Gala MD, Ryan Kern MD, David Midthun MD, John Mullon MD, Gabriel Ortiz MD, Darlene Nelson MD, Navtej S. Buttar MD

{"title":"Pleural connection treated with stent plus endobronchial valve","authors":"Mayank Goyal MBBS, Ashwariya Ohri MBBS, Preeyati Chopra MBBS, Khushboo Gala MD, Ryan Kern MD, David Midthun MD, John Mullon MD, Gabriel Ortiz MD, Darlene Nelson MD, Navtej S. Buttar MD","doi":"10.1016/j.vgie.2025.05.010","DOIUrl":"10.1016/j.vgie.2025.05.010","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Esophago-pleural fistula (EPF) is a rare but serious condition associated with high morbidity and mortality. Surgical repair remains the standard treatment; however, many patients are not surgical candidates. Endoscopic management, including clips, stents, and vascular plugs, have shown limited success, particularly for chronic fistulas.</div></div><div><h3>Methods</h3><div>A 34-year-old male with a history of sleeve gastrectomy complicated by gastrobronchial fistula underwent Roux-en-Y esophagojejunostomy and later developed a refractory EPF.</div></div><div><h3>Results</h3><div>Initial management with endoscopic and bronchoscopic placement of an endobronchial valve within a biliary metal stent was successful. Follow-up endoscopy revealed a persistent 6-mm fistula, prompting placement of an 8 mm × 6 cm fully covered biliary stent. A size 9 endobronchial valve was deployed within the stent using fluoroscopic and endoscopic guidance and functioning as a 1-way valve. This technique facilitated gradual decompression of the abscess cavity. At 6 months, imaging confirmed fistula resolution, and the stent with the valve was removed.</div></div><div><h3>Conclusions</h3><div>For nonsurgical candidates with EPF, endoscopic and bronchoscopic management provides a viable alternative. This novel approach of valve deployment within a stent offers a promising, minimally invasive solution for refractory cases.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 505-507"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242348","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Combination of through-the-scope suturing and over-the-scope clips for closure of persistent gastrocutaneous fistula after gastrostomy tube removal (“X-lock technique”) 经镜缝合与镜外夹联合治疗胃造瘘管拔除后持续性胃皮瘘（“X-lock技术”）

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.004

Sagar Shah MD, Alireza Sedarat MD, Adarsh Thaker MD

{"title":"Combination of through-the-scope suturing and over-the-scope clips for closure of persistent gastrocutaneous fistula after gastrostomy tube removal (“X-lock technique”)","authors":"Sagar Shah MD, Alireza Sedarat MD, Adarsh Thaker MD","doi":"10.1016/j.vgie.2025.05.004","DOIUrl":"10.1016/j.vgie.2025.05.004","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Persistent gastrocutaneous fistula (GCF) can occur after removal of gastrostomy tubes. Although surgical closure has historically been considered the most definitive treatment option, novel endoscopic devices have allowed for less-invasive closure techniques.</div></div><div><h3>Methods</h3><div>We present 2 cases in which closure of persistent GCF was performed using a combination of through-the-scope suturing and an over-the-scope clip (OTSC). In the first case, the suturing system and OTSC are used simultaneously, whereas in the second case, they are used sequentially.</div></div><div><h3>Results</h3><div>There were no immediate postprocedural adverse events after both procedures. Both patients resumed oral intake the day after the procedure was performed. The first patient has had no leakage from previous GCF for 2 months, and the second patient has not had recurrent leakage for over 12 months since closure.</div></div><div><h3>Conclusions</h3><div>Combination of through-the-scope suturing and OTSC placement is a viable treatment option for chronic GCF after gastrostomy tube removal.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 508-510"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242379","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Transcutaneous closure of an enterocutaneous fistula using a cardiac septal occluder 使用心间隔封堵器经皮封闭肠皮瘘

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.006

Faisal Nimri MD, Ali Kadouh MD, Taher Jamali MD, Maria Chavarria-Viales MD, Cyrus Piraka MD, Tobias Zuchelli MD

{"title":"Transcutaneous closure of an enterocutaneous fistula using a cardiac septal occluder","authors":"Faisal Nimri MD, Ali Kadouh MD, Taher Jamali MD, Maria Chavarria-Viales MD, Cyrus Piraka MD, Tobias Zuchelli MD","doi":"10.1016/j.vgie.2025.05.006","DOIUrl":"10.1016/j.vgie.2025.05.006","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Enterocutaneous fistula (ECF) is an abnormal connection between the gastrointestinal tract and skin, often managed surgically with a recent shift toward endoscopic closure. We are presenting a case highlighting the off-label use of a septal occluder, placed transcutaneously under fluoroscopy, for the closure of an ECF.</div></div><div><h3>Methods</h3><div>We are presenting a case of a 61-year-old woman with a history of metastatic colon cancer status post sigmoid resection with loop ileostomy and palliative chemotherapy. Her course was complicated by ECF with high-volume leakage. She was deemed not a surgical candidate and failed glue injections and surgical interventions.</div></div><div><h3>Results</h3><div>Endoscopy including anterograde and retrograde single balloon enteroscopy failed to reach the fistula site. The patient underwent fluoroscopic ECF closure with off-label use of a septal occluder device.</div></div><div><h3>Conclusions</h3><div>We report a successful off-label use of a septal occluder for the closure of a refractory ECF under fluoroscopic guidance with emphasis on the importance of a multidisciplinary approach and the exploration of innovative solutions in challenging clinical scenarios.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 535-539"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242385","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

EUS pancreatic rendezvous to rescue failed ERCP for postoperative pancreatic fistula after pancreaticoduodenectomy EUS胰腺会合治疗胰十二指肠切除术后胰瘘的ERCP失败

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.002

Kambiz Kadkhodayan MD , Shayan Irani MD

{"title":"EUS pancreatic rendezvous to rescue failed ERCP for postoperative pancreatic fistula after pancreaticoduodenectomy","authors":"Kambiz Kadkhodayan MD , Shayan Irani MD","doi":"10.1016/j.vgie.2025.05.002","DOIUrl":"10.1016/j.vgie.2025.05.002","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Postoperative pancreatic fistula (POPF) is a highly morbid adverse event after pancreatic surgery that occurs in up to 25% to 30% of patients. Clinically significant POPFs (grades B and C) often require a step-up approach with percutaneous and endoscopic interventions. Alternative strategies such as EUS-guided rendezvous are helpful when large pancreatojejunostomy dehiscence prevents conventional endoscopic retrograde pancreatography.</div></div><div><h3>Methods</h3><div>We present a series of 3 consecutive patients with clinically significant POPFs after the Whipple procedure in whom there was an unsuccessful percutaneous and conventional endoscopic retrograde pancreatography drainage. The median age of the patients was 62 years, their median body mass index was 40, and median pancreatic duct diameter was 2 mm.</div></div><div><h3>Results</h3><div>EUS-guided pancreatic rendezvous was performed in all cases. The median time from surgery to EUS-guided rendezvous was 28 days. Percutaneous drains were removed after a median of 20 days postprocedure. The mean stent dwell time was 123.6 days. There were no early or delayed adverse events. On median follow-up of 33 months, there were no recurrences recorded.</div></div><div><h3>Conclusions</h3><div>EUS-guided pancreatic rendezvous is a viable rescue strategy for patients with POPFs who do not respond to traditional percutaneous and endoscopic therapy. Further studies are needed.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 557-559"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Cholangioscopy miniforceps-assisted cannulation: another tool in the toolbox for difficult cannulation 胆管镜微型钳辅助插管：另一种工具，工具箱中的困难插管

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.011

Nicholas Noverati MD, Pedro Palacios Argueta MD, Faisal Kamal MD

引用次数: 0

Duodenal mucosal autotransplantation 自体十二指肠黏膜移植

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.014

Kambiz Kadkhodayan MD , Shayan Irani MD , Saurabh Chandan MD , Sagar Pathak MD , Maham Hayat MD , Abdullah Abbasi MD , Muhammad K. Hasan MD, FACG, FRCP (Glasg) , Natalie Cosgrove MD , Deepanshu Jain MD , Dennis Yang MD , Charanjeet Singh MD

{"title":"Duodenal mucosal autotransplantation","authors":"Kambiz Kadkhodayan MD , Shayan Irani MD , Saurabh Chandan MD , Sagar Pathak MD , Maham Hayat MD , Abdullah Abbasi MD , Muhammad K. Hasan MD, FACG, FRCP (Glasg) , Natalie Cosgrove MD , Deepanshu Jain MD , Dennis Yang MD , Charanjeet Singh MD","doi":"10.1016/j.vgie.2025.05.014","DOIUrl":"10.1016/j.vgie.2025.05.014","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Closure of large defects and postresection strictures can be challenging to manage after endoscopic mucosal resection (EMR) of large duodenal lesions. Duodenal mucosal autotransplantation (DAT) may offer a new strategy for defect closure and stricture prevention in patients that undergo resection of large lesions in the duodenum.</div></div><div><h3>Methods</h3><div>A 57-year-old female underwent piecemeal EMR of a duodenal adenoma involving 60% of the luminal circumference. A mucosal autograft (2 x 2 cm) was harvested from adjacent duodenum using standard EMR technique and fixed to the resection bed using helical tacks and hemostatic clips. This resulted in complete defect closure without luminal compromise.</div></div><div><h3>Results</h3><div>On follow-up EGD at 6 weeks, we noted graft incorporation, intact helix tacks and clips, and no evidence of duodenal stricture formation. The recipient site showed healthy mucosa, confirmed by biopsy, and the donor site healed well. Histopathology revealed viable duodenal mucosa with submucosal fibrosis. EGD at 6 months revealed well-healed donor and recipient sites, without evidence of stricture formation.</div></div><div><h3>Conclusions</h3><div>DAT is a feasible technique for closure of large duodenal defects and may reduce stricture risk. Further studies are warranted to evaluate long-term outcomes and broader applicability of this approach.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 529-534"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242384","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Tack-only fixation of lumen-apposing metal stents: leave the suture at home 单钉固定腔内金属支架：将缝线留在家中

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.007

Yara Salameh MD , Hadi K. Abou Zeid MD , Kamal Abi Mosleh MD , Andrew C. Storm MD

{"title":"Tack-only fixation of lumen-apposing metal stents: leave the suture at home","authors":"Yara Salameh MD , Hadi K. Abou Zeid MD , Kamal Abi Mosleh MD , Andrew C. Storm MD","doi":"10.1016/j.vgie.2025.05.007","DOIUrl":"10.1016/j.vgie.2025.05.007","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Roux-en-Y gastric bypass (RYGB) may result in refractory gastrojejunal anastomosis (GJA) strictures, which are sometimes treated with lumen-apposing metal stents (LAMSs). To prevent premature stent migration, its fixation may be considered. A tack-and-suture device, designed for through-the-scope mucosal closure, deploys a suture with 4 helical tacks that can also serve in stent fixation. We present a novel tack-only technique for LAMS fixation at the GJA for post-RYGB cases of GJA stenosis.</div></div><div><h3>Methods</h3><div>Four patients who underwent RYGB with GJA stenosis underwent LAMS placement fixated using a tack-only approach. The suture was removed ex vivo, and individual tacks were advanced and drilled through the mesh of the LAMSs’ proximal flange at multiple sites to anchor the stent.</div></div><div><h3>Results</h3><div>All 4 LAMSs were successfully fixated without adverse events. The stents remained in place beyond 8.6 weeks. One was removed endoscopically, and 2 were passed spontaneously, with all 3 patients showing resolution of stenosis and symptoms. The fourth patient has been asymptomatic with the stent still in place at 20-week follow-up, with removal planned at 24 weeks.</div></div><div><h3>Conclusions</h3><div>This pilot study suggests the potential feasibility and safety of a tack-only LAMS fixation technique at the GJA. Larger studies are needed to validate this approach.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 524-528"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242383","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic repair of Strasberg type D bile duct injury following laparoscopic cholecystectomy: an unconventional approach 腹腔镜胆囊切除术后Strasberg D型胆管损伤的内镜修复：一种非传统的方法

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.009

Ahmad Abdulraheem MD , Angela Koomson MD , Abdalla Khouqeer MD , Ahmad Al-Dwairy MD , Walid Chalhoub MD

{"title":"Endoscopic repair of Strasberg type D bile duct injury following laparoscopic cholecystectomy: an unconventional approach","authors":"Ahmad Abdulraheem MD , Angela Koomson MD , Abdalla Khouqeer MD , Ahmad Al-Dwairy MD , Walid Chalhoub MD","doi":"10.1016/j.vgie.2025.05.009","DOIUrl":"10.1016/j.vgie.2025.05.009","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Bile duct injury (BDI) is a rare but serious adverse event of laparoscopic cholecystectomy (LC). Prompt diagnosis using imaging and endoscopic tools is essential. Although most minor BDIs (Strasberg types A-C) might be managed with ERCP, major injuries (types D and E) typically require surgical intervention. This case highlights an unconventional approach in which a Strasberg type D injury was successfully managed with ERCP alone.</div></div><div><h3>Methods</h3><div>We present a case of Strasberg type D BDI following ERCP with plastic stent placement for Mirizzi’s syndrome. One day later, during LC, common bile duct (CBD) injury occurred with the stent seen intraoperatively.</div></div><div><h3>Results</h3><div>ERCP was repeated, and a guidewire was advanced through the ampulla to reconnect the transected CBD. A bridging stent restored bile flow. MRCP confirmed no leak, and CT at 4 weeks showed complete resolution of the biloma. The patient missed ERCP follow-up for bile leak and stricture evaluation.</div></div><div><h3>Conclusions</h3><div>This case challenges current guidelines recommending hepaticojejunostomy for major BDIs within 72 hours, suggesting ERCP may offer a nonsurgical alternative in select cases. MRCP may serve as a valuable tool for confirming repair success and guiding postprocedural assessment in such nonoperative management approaches.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 514-519"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Endoscopic management of active arterial bleeding in walled-off necrosis collection 内窥镜治疗闭塞性坏死收集中活动性动脉出血

VideoGIE Pub Date : 2025-10-01 DOI: 10.1016/j.vgie.2025.05.013

Matthew Eganhouse MD, Agnieszka Maniak MD, Kanika Garg MD, Thomas Wang MD, Neal A. Mehta MD, Christopher G. Chapman MD, Irving Waxman MD, Ajaypal Singh MD

{"title":"Endoscopic management of active arterial bleeding in walled-off necrosis collection","authors":"Matthew Eganhouse MD, Agnieszka Maniak MD, Kanika Garg MD, Thomas Wang MD, Neal A. Mehta MD, Christopher G. Chapman MD, Irving Waxman MD, Ajaypal Singh MD","doi":"10.1016/j.vgie.2025.05.013","DOIUrl":"10.1016/j.vgie.2025.05.013","url":null,"abstract":"<div><h3>Background and Aims</h3><div>Bleeding related to drainage of walled-off necrosis (WON) via a lumen-apposing metal stent (LAMS) and subsequent endoscopic necrosectomy is a known adverse event of the procedure. Typically, these bleeds are managed by interventional radiology. This case demonstrates successful endoscopic management of bleeding from a WON cavity.</div></div><div><h3>Methods</h3><div>A 45-year-old female underwent EUS-guided cystagsastrostomy with a LAMS for a large, symptomatic WON collection. Six days after the procedure, she presented with hematemesis. Computed tomography angiography showed blood products in the WON cavity but no active arterial extravasation. The decision was made to pursue endoscopic evaluation with EGD.</div></div><div><h3>Results</h3><div>During EGD, extensive clot extraction and removal of the LAMS allowed discovery of a pulsatile vessel in the WON cavity. This was treated with coagulation grasper forceps, ligation of vessel with hemostatic clips, and peptide matrix gel. She had no further bleeding, and WON collection resolved.</div></div><div><h3>Conclusions</h3><div>This case portrays successful endoscopic therapy for bleeding within a WON cavity. Normally, bleeding after placement of a LAMS is managed by interventional radiology. However, endoscopic therapy should be considered when imaging does not reveal active arterial extravasation or if the bleeding is intermittent in nature.</div></div>","PeriodicalId":55855,"journal":{"name":"VideoGIE","volume":"10 10","pages":"Pages 520-523"},"PeriodicalIF":0.0,"publicationDate":"2025-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145242382","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

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