The acute angulation of Roux-en-Y (R-Y) limb precludes endoscopic access for endoscopic retrograde cholangiopancreatography (ERCP) even using a balloon enteroscopy. Here, we describe a case of successful single balloon enteroscopy (SBE)-assisted ERCP using a rendezvous technique in a patient with sharply angulated R-Y limb in a 79-year-old woman who had bile duct stones. Method. At first, a gui...

An 86-year-old woman with a history of cardiac and chronic renal failure was referred to our gastroenterology outpatient clinic because of an iron deficiency anemia and intermittent, self-limited hematochezia episodes. Colonoscopy and upper endoscopy revealed no alterations. A capsule endoscopy showed a nonbleeding angioectasia in the proximal ileum. Single-balloon enteroscopy was proposed to t...

Wehere report on a novel approach to deliver a fully covered self-expanding metal stent (SEMS) into the bile duct during double-balloon enteroscopy (DBE)-assisted endoscopic retrograde cholangiopancreatography (ERCP) using the overtube as an “accessory” or working channel. An 87-year-old woman with a history of a Billroth II reconstruction many years previously and complex choledocholithiasis h...

OBJECTIVES Lipomas are the second most common benign tumors of the small bowel, and most lipomas are asymptomatic. However, lipomas with diameters of >20 mm tend to be symptomatic, for example, to cause bleeding, obstructive jaundice, abdominal pain, intestinal obstruction, intussusception, and/or perforation. METHODS/RESULTS We report a case of massive gastrointestinal bleeding from a jejuna...

Cryptogenic multifocal ulcerous stenosing enteritis (CMUSE) is a rare condition characterised by chronic or relapsing moderate ileous episodes resulting from multiple small intestinal strictures, multiple shallow ulcers of the small bowel and favourable therapeutical effect of glucocorticosteroids. The aim of this paper was to evaluate three cases of CMUSE diagnosed within 10 years at a tertiar...

Ileal Dieulafoy lesion is an unusual vascular abnormality that can cause gastrointestinal bleeding. It can be associated with massive, life-threatening hemorrhage and requires urgent angiographic intervention or surgery. Ileal Dieulafoy lesion is hard to recognize due to inaccessibility and normal-appearing mucosa. With advances in endoscopy, aggressive diagnostic and therapeutic approaches inc...

Background. There has been a growing use of both capsule endoscopy (CE) and double balloon enteroscopy (DBE) to diagnose and treat patients with obscure gastrointestinal blood loss and suspected small bowel pathology. Aim. To compare and correlate sequential CE and DBE findings in a large series of patients at two tertiary level hospitals in Wisconsin. Methods. An IRB approved retrospective stu...

Double balloon enteroscopy (DBE) was introduced 15 years ago. The complications of diagnostic DBE are rare, acute pancreatitis is most redoubtable one (incidence about 0.3%). Hyperamylasemia after DBE seems to be a rather common condition respectively. The most probable cause seems to be a mechanical straining of the pancreas. We tried to identify patients in a higher risk of acute pancreatitis...

We report a case of a 57-year-old woman with an obscure gastrointestinal bleed who was found to have an extramural gastrointestinal stromal tumour (GIST), detected by capsule endoscopy, and confirmed by laparoscopically-assisted enteroscopy and resection. Currently, major modalities used for detection of GISTs include double-balloon enteroscopy, capsule endoscopy and CT. Endoscopic measures, in...

In January 2012, a 68-year-old woman underwent laparoscopic partial gastrectomy at our institute, with Roux-en-Y reconstruction for an ulcerated gastrointestinal stromal tumor. The postoperative course was complicated by development of a duodenal stump fistula and subhepatic collection (●" Fig.1). Percutaneous drainage of the collection, as well as percutaneous transhepatic biliary drainage (PT...