EUS-guided gallbladder drainage as second option of biliary decompression after failed ERCP for the management of malignant distal biliary obstruction.

Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) is recommended as a rescue treatment of malignant distal biliary obstruction (MBDO) after failed ERCP and endoscopic ultrasound-guided biliary drainage (EUS-BD). A 64-year-old male was admitted for painless obstructive jaundice and anemia. For religious reasons, he refused any blood transfusions.

Long-standing indeterminate biliary stricture with iterative negative tissue sampling revealed as cholangiocarcinoma under SpyGlassTM cholangiocoscopy.

Bile duct brush cytology, intraductal biopsy and EUS-FNA are all used to characterize biliary strictures, with suboptimal sensitivity. Surgical resection without confirmed malignancy is undesirable. Cholangioscopy with targeted biopsies appears to increase the diagnostic yield in indeterminate biliary strictures, but it is still considered optional.

Impaired esophageal motor function in eosinophilic esophagitis.

Eosinophilic esophagitis is a chronic immunoallergic inflammatory disease of the esophagus that represents a major cause of digestive morbidity among the pediatric and young adult populations. Despite the fact that key symptoms in adults include dysphagia and food impaction, many patients lack structural changes in the esophagus to account for their complaints, which suggests the presence of underlying motor disorders and esophageal distensibility impairment. In the last few years the esophageal motility of these patients has been studied using various approaches, most particularly high-resolution manometry, ambulatory manometry, and impedance planimetry.

Normal values for water-perfused esophageal high-resolution manometry.

Background: Normal values for water-perfused esophageal high-resolution manometry have still not been established in our environment, despite its generalized use and the recommendation to determine reference values for each Motility Unit based on their equipment. Normal values established with solid-state highresolution manometry are currently being used as reference values for water-perfused high-resolution manometry.

Objectives: To obtain normal values for water-perfused esophageal high-resolution manometry, based on the esophageal motility analysis of healthy subjects.

[Hemoconcentration, Apache II and Ranson as early predictors of severity in patients with acute pancreatitis in a hospital in Lima - Peru].

Objective: Compare hemoconcetration, APACHE II and Ranson scores as early predictors of severity defined by Atlanta criteria in patients with acute pancreatitis at Hospital Nacional Cayetano Heredia.

Materials And Methods: Retrospective descriptive study between December 2009 to November 2010 done using a data collection sheet to gather study relevant information. We classified acute pancreatitis into mild or severe according to Atlanta symposium criteria for organ failure and/or local complications.