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Volume 51(6); November 2018
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Commentarys
Multiple White Flat Lesions of the Corpus: Subtype of Hyperplastic Polyps vs. Intestinal Metaplasia
Su Jin Kim, Cheol Woong Choi
Clin Endosc 2018;51(6):503-504.   Published online October 31, 2018
DOI: https://doi.org/10.5946/ce.2018.162
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The Usefulness of New-Generation Capsule Endoscopy in Patients with Portal Hypertensive Enteropathy
Seung-Joo Nam, Ji Hyun Kim, Sung Chul Park
Clin Endosc 2018;51(6):505-507.   Published online November 19, 2018
DOI: https://doi.org/10.5946/ce.2018.165
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  • 81 Download
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Refractory Irritable Bowel Syndrome and Functional Abdominal Pain Syndrome: Should Small Bowel Endoscopy Be Performed?
Sung Kyun Yim, Sang Wook Kim
Clin Endosc 2018;51(6):508-509.   Published online November 9, 2018
DOI: https://doi.org/10.5946/ce.2018.157
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Will New Instruments for Endoscopic Ultrasound-Guided Tissue Acquisition Make Us Happy?
Chang-Il Kwon
Clin Endosc 2018;51(6):510-512.   Published online November 23, 2018
DOI: https://doi.org/10.5946/ce.2018.164
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Citations

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    Guru Trikudanathan, Dale Snover, Shawn J Mallery
    Clinical Endoscopy.2019; 52(3): 293.     CrossRef
  • Which Needle Needs to Be Chosen for Better Outcome of Endoscopic Ultrasound-Guided Tissue Acquisition?
    Dong Wook Lee, Eun Young Kim
    Gut and Liver.2019; 13(3): 223.     CrossRef
  • Present and Future of Endoscopic Ultrasound-Guided Tissue Acquisition in Solid Pancreatic Tumors
    Jae Keun Park, Kwang Hyuck Lee
    Clinical Endoscopy.2019; 52(6): 541.     CrossRef
  • 5,469 View
  • 88 Download
  • 6 Web of Science
  • 5 Crossref
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Focused Review Series: Current Statuses of Image-Enhanced Endoscopy (IEE)
Linked Color Imaging and Blue Laser Imaging for Upper Gastrointestinal Screening
Hiroyuki Osawa, Yoshimasa Miura, Takahito Takezawa, Yuji Ino, Tsevelnorov Khurelbaatar, Yuichi Sagara, Alan Kawarai Lefor, Hironori Yamamoto
Clin Endosc 2018;51(6):513-526.   Published online November 2, 2018
DOI: https://doi.org/10.5946/ce.2018.132
AbstractAbstract PDFPubReaderePub
White light imaging (WLI) may not reveal early upper gastrointestinal cancers. Linked color imaging (LCI) produces bright images in the distant view and is performed for the same screening indications as WLI. LCI and blue laser imaging (BLI) provide excellent visibility of gastric cancers in high color contrast with respect to the surrounding tissue. The characteristic purple and green color of metaplasias on LCI and BLI, respectively, serve to increase the contrast while visualizing gastric cancers regardless of a history of Helicobacter pylori eradication.
LCI facilitates color-based recognition of early gastric cancers of all morphological types, including flat lesions or those in an H. pylori-negative normal background mucosa as well as the diagnosis of inflamed mucosae including erosions. LCI reveals changes in mucosal color before the appearance of morphological changes in various gastric lesions. BLI is superior to LCI in the detection of early esophageal cancers and abnormal findings of microstructure and microvasculature in close-up views of upper gastrointestinal cancers. Excellent images can also be obtained with transnasal endoscopy. Using a combination of these modalities allows one to obtain images useful for establishing a diagnosis. It is important to observe esophageal cancers (brown) using BLI and gastric cancers (orange) surrounded by intestinal metaplasia (purple) and duodenal cancers (orange) by LCI.

Citations

Citations to this article as recorded by  
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    Reza Ranjbar, Amir Ebrahimi, Amirhossein Sahebkar
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  • Linked color imaging versus conventional white light colonoscopy for the detection of colorectal polyps
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    Cochrane Database of Systematic Reviews.2023;[Epub]     CrossRef
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    Sang Pyo Lee
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  • Landscape of Innovative Methods for Early Diagnosis of Gastric Cancer: A Systematic Review
    Alexandra Orășeanu, Mihaela Cristina Brisc, Octavian Adrian Maghiar, Horia Popa, Ciprian Mihai Brisc, Sabina Florina Șolea, Teodor Andrei Maghiar, Ciprian Brisc
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  • Incidence of Infection among Subjects with Helicobacter pylori Seroconversion
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  • Linked color imaging effectively detects the endoscopic atrophic border in transnasal endoscopy
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    Masahiro Saito, Tomoyuki Koike, Yuki Ohara, Kenichiro Nakagawa, Takeshi Kanno, Xiaoyi Jin, Waku Hatta, Kaname Uno, Naoki Asano, Akira Imatani, Atsushi Masamune
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  • The Efficacy of Linked Color Imaging in the Endoscopic Diagnosis of Barrett’s Esophagus and Esophageal Adenocarcinoma
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  • Linked color imaging can improve the visibility of superficial non-ampullary duodenal epithelial tumors
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    Joon Sung Kim, Byung-Wook Kim
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  • Review: Diagnosis of Helicobacter pylori infection
    Athanasios Makristathis, Alexander M. Hirschl, Francis Mégraud, Emilie Bessède
    Helicobacter.2019;[Epub]     CrossRef
  • New Diagnostic Approach for Esophageal Squamous Cell Neoplasms Using Linked Color Imaging and Blue Laser Imaging Combined with Iodine Staining
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  • Linked color imaging for the detection of early gastrointestinal neoplasms
    Satoshi Shinozaki, Hiroyuki Osawa, Yoshikazu Hayashi, Alan Kawarai Lefor, Hironori Yamamoto
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  • Linked Color Imaging Highlights Flat Early Gastric Cancer
    Kimitoshi Kubo, Noriko Kimura, Soichiro Matsuda, Momoko Tsuda, Mototsugu Kato
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Usefulness of Narrow-Band Imaging in Endoscopic Submucosal Dissection of the Stomach
Jung-Wook Kim
Clin Endosc 2018;51(6):527-533.   Published online November 19, 2018
DOI: https://doi.org/10.5946/ce.2018.186
AbstractAbstract PDFPubReaderePub
There have been many advances in endoscopic imaging technologies. Magnifying endoscopy with narrow-band imaging is an innovative optical technology that enables the precise discrimination of structural changes on the mucosal surface. Several studies have demonstrated its usefulness and superiority for tumor detection and differential diagnosis in the stomach as compared with conventional endoscopy. Furthermore, magnifying endoscopy with narrow-band imaging has the potential to predict the invasion depth and tumor margins during gastric endoscopic submucosal dissection. Classifications of the findings of magnifying endoscopy with narrow-band imaging based on microvascular and pit patterns have been proposed and have shown excellent correlations with invasion depth confirmed by microscopy. In terms of tumor margin prediction, magnifying endoscopy with narrow-band imaging offers superior delineation of gastric tumor margins compared with traditional chromoendoscopy with indigo carmine. The limitations of narrow-band imaging, such as the need for considerable training, long procedure time, and lack of studies about its usefulness in undifferentiated cancer, should be resolved to confirm its value as a complementary method to endoscopic submucosal dissection. However, the role of magnifying endoscopy with narrow-band imaging is expected to increase steadily with the increasing use of endoscopic submucosal dissection for the treatment of gastric tumors.

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Image-Enhanced Endoscopy in Lower Gastrointestinal Diseases: Present and Future
Han Hee Lee, Bo-In Lee
Clin Endosc 2018;51(6):534-540.   Published online November 30, 2018
DOI: https://doi.org/10.5946/ce.2018.187
AbstractAbstract PDFPubReaderePub
From dye-assisted conventional chromoendoscopy to novel virtual chromoendoscopy, image-enhanced endoscopy (IEE) is continuously evolving to meet clinical needs and improve the quality of colonoscopy. Dye-assisted chromoendoscopy using indigo carmine or crystal violet, although slightly old-fashioned, is still useful to emphasize the pit patterns of the colonic mucosa and predict the histological structures of relevant lesions. Equipment-based virtual chromoendoscopy has the advantage of being relatively easy to use. There are several types of virtual chromoendoscopy that vary depending on the manufacturer and operating principle. IEE plays distinctive roles with respect to histologic characterization of colorectal polyps and prediction of the invasion depth of colorectal cancers. In addition, the newest models of IEE have the potential to increase adenoma and polyp detection rates in screening colonoscopy.

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Role of Image-Enhanced Endoscopy in Pancreatobiliary Diseases
Yun Nah Lee, Jong Ho Moon, Hyun Jong Choi
Clin Endosc 2018;51(6):541-546.   Published online November 30, 2018
DOI: https://doi.org/10.5946/ce.2018.203
AbstractAbstract PDFPubReaderePub
Recent advances in cholangiopancreatoscopy technology permit image-enhanced endoscopy (IEE) for pancreatobiliary diseases. There are limitations in endoscopy performance and in the study of the clinical role of IEE in bile duct or pancreatic duct diseases. However, currently available IEEs during cholangiopancreatoscopy including traditional dye-aided chromoendoscopy, autofluorescence imaging, narrow-band imaging, and i-Scan have been evaluated and reported previously. Although the clinical role of IEE in pancreatobiliary diseases should be verified in future studies, IEE is a useful promising tool in the evaluation of bile duct or pancreatic duct mucosal lesions.

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Reviews
Application of Artificial Intelligence in Capsule Endoscopy: Where Are We Now?
Youngbae Hwang, Junseok Park, Yun Jeong Lim, Hoon Jai Chun
Clin Endosc 2018;51(6):547-551.   Published online November 30, 2018
DOI: https://doi.org/10.5946/ce.2018.173
AbstractAbstract PDFPubReaderePub
Unlike wired endoscopy, capsule endoscopy requires additional time for a clinical specialist to review the operation and examine the lesions. To reduce the tedious review time and increase the accuracy of medical examinations, various approaches have been reported based on artificial intelligence for computer-aided diagnosis. Recently, deep learning–based approaches have been applied to many possible areas, showing greatly improved performance, especially for image-based recognition and classification. By reviewing recent deep learning–based approaches for clinical applications, we present the current status and future direction of artificial intelligence for capsule endoscopy.

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Robotics for Advanced Therapeutic Colonoscopy
Jennie Y Y Wong, Khek Yu Ho
Clin Endosc 2018;51(6):552-557.   Published online August 21, 2018
DOI: https://doi.org/10.5946/ce.2018.089
AbstractAbstract PDFPubReaderePub
Although colonoscopy was originally a diagnostic imaging procedure, it has now expanded to include an increasing range of therapeutic interventions. These procedures require precise maneuvers of instruments, execution of force, efficient transmission of force from the operator to the point of application, and sufficient dexterity in the mobilization of endoscopic surgical instruments. The conventional endoscope is not designed to support technically demanding endoscopic procedures. In case of colonoscopy, the tortuous anatomy of the colon makes inserting, moving, and orientating the endoscope difficult. Exerting excessive pressure can cause looping of the endoscope, pain to the patient, and even perforation of the colon. To mitigate the technical constraints, numerous technically enhanced systems have been developed to enable better control of instruments and precise delivery of force in the execution of surgical tasks such as apposing, grasping, traction, counter-traction, and cutting of tissues. Among the recent developments are highly dexterous robotic master and slave systems, computer-assisted or robotically enhanced conventional endoscopes, and autonomously driven locomotion devices that can effortlessly traverse the colon. Developments in endoscopic instrumentations have overcome technical barriers and opened new horizons for further advancements in therapeutic interventions. This review describes examples of some of these systems in the context of their applications to advanced therapeutic colonoscopy.

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Original Articles
Magnified Endoscopic Findings of Multiple White Flat Lesions: A New Subtype of Gastric Hyperplastic Polyps in the Stomach
Rino Hasegawa, Kenshi Yao, Shoutomi Ihara, Masaki Miyaoka, Takao Kanemitsu, Kenta Chuman, Go Ikezono, Akikazu Hirano, Toshiharu Ueki, Hiroshi Tanabe, Atsuko Ota, Seiji Haraoka, Akinori Iwashita
Clin Endosc 2018;51(6):558-562.   Published online November 21, 2018
DOI: https://doi.org/10.5946/ce.2018.104
AbstractAbstract PDFPubReaderePub
Background
/Aims: While the occurrence of multiple whitish flat elevated lesions (MWFL) was first reported in 2007, no studies on MWFL have been published to date. The present retrospective observational study aimed to clarify the endoscopic findings and clinicopathological features of MWFL.
Methods
Subjects were consecutive patients who underwent upper gastrointestinal endoscopy as part of routine screening between April 2014 and March 2015. The conventional white-light, non-magnifying and magnifying narrow-band images were reviewed. Clinical features were compared between patients with and without MWFL.
Results
The conventional endoscopic findings of MWFL include multiple whitish, flat, and slightly elevated lesions of various sizes, mainly located in the gastric body and fundus. Narrow-band imaging enhanced the contrast of MWFL and background mucosa, and magnifying narrow-band imaging depicted a uniformly long, narrow, and elliptical marginal crypt epithelium with an unclear microvascular pattern. Histopathological findings revealed hyperplastic changes of the foveolar epithelium, and parietal cell protrusions and oxyntic gland dilatations were observed in the fundic glands, without any intestinal metaplasia. The rate of acid-reducing drug use was significantly higher in patients with MWFL than in those without (100% [13/13] vs. 53.7% [88/164], p<0.001).
Conclusions
The present study indicated a relationship between the presence and endoscopic features of MWFL and history of acidreducing drug use.

Citations

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    Su Jin Kim, Cheol Woong Choi
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Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System
Mahesh Kumar Goenka, Bhavik Bharat Shah, Vijay Kumar Rai, Surabhi Jajodia, Usha Goenka
Clin Endosc 2018;51(6):563-569.   Published online October 5, 2018
DOI: https://doi.org/10.5946/ce.2018.041
AbstractAbstract PDFPubReaderePub
Background
/Aims: To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system.
Methods
Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined.
Results
Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement.
Conclusions
The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.

Citations

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    Uday C. Ghoshal, Akash Roy, Mahesh K. Goenka
    Indian Journal of Gastroenterology.2024;[Epub]     CrossRef
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    Thomas H Tranah, Jeremy S Nayagam, Stephen Gregory, Sarah Hughes, David Patch, Dhiraj Tripathi, Debbie L Shawcross, Deepak Joshi
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    Seung-Joo Nam, Ji Hyun Kim, Sung Chul Park
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Capsule Endoscopy in Refractory Diarrhea-Predominant Irritable Bowel Syndrome and Functional Abdominal Pain
Manuel Valero, Gladys Bravo-Velez, Roberto Oleas, Miguel Puga-Tejada, Miguel Soria-Alcívar, Haydee Alvarado Escobar, Jorge Baquerizo-Burgos, Hannah Pitanga-Lukashok, Carlos Robles-Medranda
Clin Endosc 2018;51(6):570-575.   Published online November 16, 2018
DOI: https://doi.org/10.5946/ce.2018.055
AbstractAbstract PDFPubReaderePub
Background
/Aims: Capsule endoscopy is a diagnostic method for evaluating the small bowel lumen and can detect undiagnosed lesions. The aim of this study was to evaluate the diagnostic yield and clinical impact of capsule endoscopy in patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain.
Methods
This study involved a retrospective analysis of prospectively collected data, maintained in a database. Patients with refractory diarrhea-predominant irritable bowel syndrome and functional abdominal pain within the period of March 2012 to March 2014 were included. Capsule endoscopy was used to detect small bowel pathologies in both groups.
Results
Sixty-five patients (53.8% female) fulfilled the inclusion criteria and had a mean (±standard deviation) age of 50.9±15.9 years. Clinically significant lesions were detected via capsule endoscopy in 32.5% of the patients in the abdominal pain group and 54.5% of the patients in the diarrhea group. Overall, 48% of patients had small bowel pathologies detected during the capsule endoscopy study. Inflammatory lesions and villous atrophy were the most frequent lesions identified in 16.9% and 15.3% of patients in the abdominal pain and the diarrhea groups, respectively.
Conclusions
Routine use of capsule endoscopy in patients with irritable bowel syndrome should not be recommended. However, in patients with refractory conditions, capsule endoscopy may identify abnormalities.

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Prospective Assessment of the Performance of a New Fine Needle Biopsy Device for EUS-Guided Sampling of Solid Lesions
Ihab I. El Hajj, Howard Wu, Sarah Reuss, Melissa Randolph, Akeem Harris, Mark A. Gromski, Mohammad Al-Haddad
Clin Endosc 2018;51(6):576-583.   Published online July 13, 2018
DOI: https://doi.org/10.5946/ce.2018.053
AbstractAbstract PDFPubReaderePub
Background
/Aims: Endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) remains the most common EUS-guided tissue acquisition technique. This study aimed to evaluate the performance of a new Franseen tip fine needle biopsy (FNB) device for EUSguided sampling of solid lesions and compare it with the historical FNA technique.
Methods
Acquire® 22 G FNB needle (Boston Scientific Co., Natick, MA, USA) was used for solid tumor sampling (Study group). Tissue was collected for rapid on-site evaluation, and touch and crush preparations were made. Historical EUS-FNA samples obtained using Expect® 22 G FNA needle (Boston Scientific Co.) were used as controls (Control group). All specimens were independently evaluated by two cytopathologists blinded to the formal cytopathological diagnosis.
Results
Mean cell block histology scores were significantly higher (p=0.046) in the FNB group (51 samples) despite a significantly lower (p<0.001) mean number of passes compared to the FNA group (50 specimens). The overall diagnostic yields for the FNB vs. FNA groups were 96% vs. 88%. The degree of tumor differentiation was adequately assessed in all cell block qualifying lesions in the FNB group. Two patients developed post-FNB abdominal pain.
Conclusions
The new Franseen tip FNB device provides histologically superior and cytologically comparable specimens to those obtained by FNA, but with fewer passes.

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Case Reports
Gastric Ulceration and Bleeding with Hemodynamic Instability Caused by an Intragastric Balloon for Weight Loss
Larrite Reed, Hawa Edriss, Kenneth Nugent
Clin Endosc 2018;51(6):584-586.   Published online June 1, 2018
DOI: https://doi.org/10.5946/ce.2018.038
AbstractAbstract PDFPubReaderePub
Obesity in the United States is a medical crisis with many people attempting to lose weight with caloric restriction. Some patients choose minimally invasive weight loss solutions, such as intragastric balloon systems. These balloon systems were approved by the Federal Drug Administration (FDA) in 2015–2016 and have been considered safe, with minimal side effects. We report a patient with a two-day history of melena, abdominal pain, hypotension, and syncope which developed five months after placement of an intragastric balloon. Esophagogastroduodenoscopy with balloon removal revealed a small 8-mm gastric ulcer in the incisura. This gastric ulcer probably developed secondary to mechanical compression of the stomach mucosa by the gastric balloon which contained 900 mL of saline. The FDA is now investigating five deaths since 2016 associated with these second-generation balloons. Clinicians should be aware of these complications when evaluating patients with gastrointestinal complications, such as bleeding.

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A Rare Duodenal Subepithelial Tumor: Duodenal Schwannoma
Dong Hwahn Kahng, Gwang Ha Kim, Sang Gyu Park, So Jeong Lee, Do Youn Park
Clin Endosc 2018;51(6):587-590.   Published online May 15, 2018
DOI: https://doi.org/10.5946/ce.2018.050
AbstractAbstract PDFPubReaderePub
Schwannomas are uncommon neoplasms that arise from Schwann cells of the neural sheath. Gastrointestinal schwannomas are rare among mesenchymal tumors of the gastrointestinal tract, and only a few cases have been reported to date. Duodenal schwannomas are usually discovered incidentally and achieving a preoperative diagnosis is difficult. Schwannomas can be distinguished from other subepithelial tumors on endoscopic ultrasonography; however, any typical endosonographic features of duodenal schwannomas have not been reported due to the rarity of these tumors. Immunohistochemistry is essential to distinguish schwannomas from gastrointestinal stromal tumors and leiomyomas. We report a case of duodenal schwannoma found incidentally during a health check-up endoscopy. On endoscopic ultrasonography, this tumor was suspected as a gastrointestinal stromal tumor; therefore, the patient underwent laparoscopic wedge resection of the tumor. Histopathology and immunohistochemistry confirmed that the duodenal lesion was a benign schwannoma.

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Intussusception after Colonoscopy: A Case Report and Review of Literature
Wan Amir Wan Hassan, William Teoh
Clin Endosc 2018;51(6):591-595.   Published online October 5, 2018
DOI: https://doi.org/10.5946/ce.2018.056
AbstractAbstract PDFPubReaderePub
Intussusception after colonoscopy is an unusual complication. A MEDLINE search revealed only 7 reported cases. We present a report of a 28-year-old man who developed abdominal pain several hours after routine colonoscopy and in whom computed tomography (CT) revealed colocolic intussusception. We postulate that this condition is iatrogenic and induced by suctioning of gas on withdrawal of the colonoscope. A common observation among the reported cases was abdominal pain several hours after colonoscopy and right-sided intussusception. All cases had colonoscopy reaching the right side of the colon. Treatment for adult intussusception remains controversial with regard to reduction versus resection, especially given the high association with a pathological cause and malignancy. Among the 8 reported cases, only the current case did not require surgery. A combination of benign colonoscopy, CT, and the clinical picture should provide sufficient information to initially choose a more conservative treatment approach.

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    Atif Jastaniah, Nasra AlBusaidi, Pouya Bandegi, Jeremy Grushka
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    Edison Vadakkenchery Varghese, Christopher Steen, Karolina Juszczyk, Vinna An
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Treatment Using the SpyGlass Digital System in a Patient with Hepatolithiasis after a Whipple Procedure
Hirofumi Harima, Kouichi Hamabe, Fusako Hisano, Yuko Matsuzaki, Tadahiko Itoh, Kazutoshi Sanuki, Isao Sakaida
Clin Endosc 2018;51(6):596-599.   Published online May 23, 2018
DOI: https://doi.org/10.5946/ce.2018.057
AbstractAbstract PDFSupplementary MaterialPubReaderePub
An 89-year-old man was referred to our hospital for treatment of hepatolithiasis causing recurrent cholangitis. He had undergone a prior Whipple procedure. Computed tomography demonstrated left-sided hepatolithiasis. First, we conducted peroral direct cholangioscopy (PDCS) using an ultraslim endoscope. Although PDCS was successfully conducted, it was unsuccessful in removing all the stones. The stones located in the B2 segment were difficult to remove because the endoscope could not be inserted deeply into this segment due to the small size of the intrahepatic bile duct. Next, we substituted the endoscope with an upper gastrointestinal endoscope. After positioning the endoscope, the SpyGlass digital system (SPY-DS) was successfully inserted deep into the B2 segment. Upon visualizing the residual stones, we conducted SPY-DS-guided electrohydraulic lithotripsy. The stones were disintegrated and completely removed. In cases of PDCS failure, a treatment strategy using the SPY-DS can be considered for patients with hepatolithiasis after a Whipple procedure.
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Brief Report
Case Series Review of the Safety and Efficacy of Endoscopic Ultrasound-Guided Splenic Mass Core Biopsy
Sammy Saab, Youssef Challita, David Holloman, Kelli Hathaway, Michel Kahaleh, Jose Nieto
Clin Endosc 2018;51(6):600-601.   Published online October 4, 2018
DOI: https://doi.org/10.5946/ce.2017.174
PDFPubReaderePub

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Letter to the editor
Button Battery Ingestion in Children: A Specific Clinical Issue
Francesco Macchini, Elettra Vestri, Martina Ichino, Anna Morandi, Giorgio Fava, Ernesto Leva
Clin Endosc 2018;51(6):602-603.   Published online October 31, 2018
DOI: https://doi.org/10.5946/ce.2018.137
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