UK and Ireland Joint Advisory Group (JAG) consensus statements for training and certification in diagnostic endoscopic ultrasound (EUS).

Background And Aims: International endoscopy societies vary in their approach for credentialing individuals in endoscopic ultrasound (EUS) to enable independent practice; however, there is no consensus in this or its implementation. In 2019, the Joint Advisory Group on GI Endoscopy (JAG) commissioned a working group to examine the evidence relating to this process for EUS. The aim of this was to develop evidence-based recommendations for EUS training and certification in the UK.

Localising ingested metallic foreign bodies to guide surgical planning: A novel use for the CT metal artefact reduction algorithm.

We present the case of a 20-year-old female patient who presented following ingestion of multiple button magnets. She remained clinically well however serial abdominal radiographs demonstrated the magnets were not passing through the gastrointestinal tract and a CT was, therefore, performed for further assessment and to aid surgical planning. Artefact from the magnets made interpretation of the CT challenging.

Single slide assessment: A highly effective cytological rapid on-site evaluation technique for endobronchial and endoscopic ultrasound-guided fine needle aspiration.

No standardised, comprehensive approach to rapid on-site evaluation (ROSE) of cytology samples currently exists. Recent meta-analysis indicates variation in the effectiveness of ROSE, however, reviews commonly omit the details of how ROSE is conducted. This review demonstrates the clinical effectiveness of single slide assessment (SSA) for ROSE of cytology samples, providing a highly effective, standardised methodology, maximising cell yield and the diagnostic potential of samples obtained via endobronchial or endoscopic ultrasound.

The case of the mysterious vanishing spleen: autosplenectomy complicating pneumococcal sepsis.

A 57-year-old previously healthy fisherman was admitted in fulminant pneumococcal septic shock, with disseminated intravascular coagulation, requiring aggressive management including bilateral below-knee amputations for ischaemic necrosis. He began to recover and was discharged for rehabilitation, however during his convalescence was found to be hypercalcaemic. No malignancy was found on CT scan, but it was noted that his spleen was absent, replaced by a 4 cm smooth-walled, fluid-filled lesion.