How to perform direct percutaneous gastrostomy with T-fastener gastropexy using endoscopic guidance.

Demonstration of how to perform direct percutaneous gastrostomy with gastropexy T-fasteners using endoscopic guidance.

Mortality Trends, Outcomes, and Predictors of Portal Vein Thrombosis in Acute Pancreatitis Patients: A Propensity-Matched National Study.

Background: Portal vein thrombosis (PVT) is a rare complication of acute pancreatitis (AP) and might be associated with worse outcomes. We aimed to study trends, outcomes, and predictors of PVT in AP patients.

Methods: The National Inpatient Sample database was utilized to identify the adult patients (≥ 18 years) with primary diagnosis of AP from 2004 to 2013 using International Classification of Disease, Ninth Revision.

Endoscopic management of severe colo-colonic anastomotic stricture.

Video 1A therapeutic approach: endoscopic management of severe colo-colonic anastomotic stricture.

Mesenchymal stem cells: A novel treatment option for primary sclerosing cholangitis.

Primary sclerosing cholangitis (PSC) is a progressive liver disease for which there is no effective therapy. Hepatocytes and cholangiocytes from a PSC patient were cocultured with mesenchymal stem cells (MSCs) to assess in vitro change. A single patient with progressive PSC was treated with 150 million MSCs via direct injection into the common bile duct.

Endoscopic ultrasound with combined fine needle aspiration plus biopsy improves diagnostic yield in solid pancreatic masses.

Goals: Our aim was to compare the diagnostic yield of endoscopic ultrasound guided fine needle aspiration (EUS-FNA) versus combined fine needle aspiration and fine needle biopsy (EUS-FNA + FNB) in the evaluation of solid pancreatic masses (SPMs).

Background: EUS-FNA and EUS-FNB are established methods to diagnose SPMs. No studies have evaluated the efficacy of combination of both (EUS-FNA + FNB).

Treatment of refractory benign gastroenteral strictures with fully covered metal stents.

Video 1Treatment of refractory benign gastroenteral strictures with fully covered metal stents.

Trends and risk factors for 30-day readmissions in patients with acute cholangitis: analysis from the national readmission database.

Introduction: Acute cholangitis (AC) can be associated with significant mortality and high risk of readmissions, if not managed promptly. We used national readmission database (NRD) to identify trends and risk factors associated with 30-day readmissions in patients with AC.

Methods: We conducted a retrospective cohort study of adult patients admitted with AC from 2010-2014 and Q1-Q3 of 2015 by extracting data from NRD.

Kinetics of Gallbladder Emptying During Cholecystokinin Cholescintigraphy as an Indicator of In Vivo Hormonal Sensitivity.

Cholecystokinin cholescintigraphy is used clinically to quantify gallbladder ejection fraction as an indicator of functional gallbladder disorder. It can also provide the opportunity to quantify an individual's responsiveness to the physiologic stimulant of gallbladder contraction, cholecystokinin, which is a major regulator of appetite and postprandial satiety. In the current work, we use cholecystokinin cholescintigraphy to quantify the kinetics of gallbladder emptying, including average and peak rates, in response to a standard cholecystokinin infusion.

Intestinal metaplasia of the gastric cardia: findings in patients with versus without Barrett's esophagus.

Background And Aims: There is controversy about finding intestinal metaplasia (IM) of the gastric cardia on biopsy. The most recent American College of Gastroenterology guideline comments that IM cardia is not more common in patients with Barrett's esophagus (BE). It provides limited guidance on whether the cardia should be treated when patients with BE undergo endoscopic eradication therapy (EET) and whether the cardia should undergo biopsy after ablation.

Comparison of Small Versus Large Volume Split Dose Preparation for Colonoscopy: A Study of Colonoscopy Outcomes.

Background: Split dose bowel preparations (SDP) have superior outcomes for colonoscopy as compared to evening before regimens. However, the association of the actual volume of the SDP to colonoscopy outcome measures has not been well studied.

Aims: Compare adenoma detection rate (ADR), sessile serrated polyp detection rate (SDR), mean bowel cleanse score, and predictors of inadequate exams between small volume SDP and large volume SDP.

Prospective blinded comparison of wireless capsule endoscopy and multiphase CT enterography in obscure gastrointestinal bleeding.

Purpose: To compare the performance of multiphase computed tomographic (CT) enterography with that of capsule endoscopy in a group of patients with obscure gastrointestinal bleeding (OGIB).

Materials And Methods: This prospective HIPAA-compliant study was approved by the institutional review board and the institutional conflict of interest committee. All patients provided written informed consent.

Computed tomography enterography detects intestinal wall changes and effects of treatment in patients with Crohn's disease.

Background & Aims: The use of computed tomography enterography (CTE) in patients with Crohn's disease has increased. However, there is little data available on how radiologic parameters of active disease change during treatment with infliximab and whether these changes correspond to symptoms, serum biomarkers, or endoscopic appearance.

Methods: We performed a retrospective study of patients with Crohn's disease who had undergone serial CTE imaging while receiving infliximab.

Benefit of computed tomography enterography in Crohn's disease: effects on patient management and physician level of confidence.

Background: Computed tomographic enterography (CTE) has been shown to have a high sensitivity and specificity for active small bowel inflammation. There are only sparse data on the effect of CTE results on Crohn's disease (CD) patient care.

Methods: We prospectively assessed 273 patients with established or suspected CD undergoing a clinically indicated CTE.

Appropriate patient selection at abdominal dual-energy CT using 80 kV: relationship between patient size, image noise, and image quality.

Purpose: To determine the computed tomographic (CT) detector configuration, patient size, and image noise limitations that will result in acceptable image quality of 80-kV images obtained at abdominal dual-energy CT.

Materials And Methods: The Institutional Review Board approved this HIPAA-compliant retrospective study from archival material from patients consenting to the use of medical records for research purposes. A retrospective review of contrast material-enhanced abdominal dual-energy CT scans in 116 consecutive patients was performed.

Incidental findings in imaging research: evaluating incidence, benefit, and burden.

Background: Little information exists concerning the frequency and medical significance of incidental findings (IFs) in imaging research.

Methods: Medical records of research participants undergoing a research imaging examination interpreted by a radiologist during January through March 2004 were reviewed, with 3-year clinical follow-up. An expert panel reviewed all IFs generating clinical action to determine medical benefit/burden on the basis of predefined criteria.

Validation of a lower radiation computed tomography enterography imaging protocol to detect Crohn's disease in the small bowel.

Background: The purpose was to validate a lower radiation dose computed tomography enterography (CTE) imaging protocol to detect the presence of Crohn's disease (CD) in the small bowel using two different reference standards and to identify a prediction model based on CTE signs for the presence of active CD.

Methods: This retrospective study included patients with known or suspected CD who underwent CTE between January and October 2006 according to a lower radiation dose protocol. Two gastrointestinal radiologists blindly and independently classified each CTE as being active or inactive.

Bedside quantification of dead-space fraction using routine clinical data in patients with acute lung injury: secondary analysis of two prospective trials.

Introduction: Dead-space fraction (Vd/Vt) has been shown to be a powerful predictor of mortality in acute lung injury (ALI) patients. The measurement of Vd/Vt is based on the analysis of expired CO2 which is not a part of standard practice thus limiting widespread clinical application of this method. The objective of this study was to determine prognostic value of Vd/Vt estimated from routinely collected pulmonary variables.

Assessment of appropriateness of indications for CT enterography in younger patients.

Background: The small potential risk of radiation-induced cancer is increased in younger patients undergoing serial imaging with computed tomography enterography (CTE). We sought to determine the appropriateness of CTEs based on clinical indication in patients < or =35 years old, and the potential impact of evolution of practice to alternative magnetic resonance enterography (MRE).

Methods: Over a 7-year period, the medical records of all patients < or =35 years old undergoing CTE were reviewed to determine the clinical indications for each CTE exam.