Multifocal Pyloric Gland Adenoma of the Esophagus Treated by Circumferential Endoscopic Submucosal Dissection.

Pyloric gland adenoma is a rare neoplasm of the gastrointestinal tract typically observed in the stomach with a substantial malignant potential warranting its resection. While isolated esophageal pyloric gland adenoma has been reported, there is no literature on the encounter of diffuse, multifocal esophageal pyloric gland adenoma or its management. We present a unique case of multifocal pyloric gland adenoma of the esophagus treated by circumferential endoscopic submucosal dissection.

Early Cardiac Dysfunction in Biopsy-proven Nonalcoholic Fatty Liver Disease.

Backgrounds/aims: Nonalcoholic fatty liver disease (NAFLD) encompasses a range of diseases from nonalcoholic fatty liver (NAFL) to nonalcoholic steatohepatitis (NASH) and has been linked to cardiovascular disease and sub-clinical cardiac remodeling. This paper presents a retrospective study of biopsy-proven NAFL and NASH to examine the differences in subclinical cardiac remodeling.

Methods: Patients were recruited from an institutional repository of patients with liver-biopsy-confirmed NAFLD.

Access fistulotomy: technical tips for success.

Background And Aims: Biliary cannulation, although critical to procedural success in ERCP, can be difficult and, if unsuccessful, can lead to longer hospital stays, repeat procedures, and increased costs. Expertise in adjunct techniques, including access fistulotomy, can increase success rates and potentially avoid these issues. The aim of this case series is to describe the technique of access fistulotomy and illustrate key points that are important for successful biliary access.

Choledochoscope with stent placement for treatment of benign duodenal strictures: A case report.

Background: Endoscopically or fluoroscopically guided dilation is a safe and effective alternative to surgery for patients with benign strictures of the gastric outlet.

Case Summary: We describe two cases where a novel approach with a Spyglass choledochoscope in assessing the extent of benign duodenal strictures and aiding in placement of duodenal stents for treatment of the strictures. Choledochoscope-guided wire and stent placement was successful in all cases, leading to symptom resolution related to benign duodenal obstruction.

Novel Use of a Uniquely Designed, Lumen-Apposing, Metal Stent in Benign Gastric Outlet Obstruction in Two Patients.

Current guidelines recommend management of benign gastric outlet obstruction (GOO) with serial dilations. Self-expanding metal stents are effective, but their use is complicated by high rates of migration. We present two cases from our institution where a uniquely designed, lumen-apposing metal stent (LAMS) was successfully used to alleviate benign GOO without stent migration.

The effect of statin therapy on the incidence of infections: a retrospective cohort analysis.

Background: Statins have been postulated to prevent infection through immunomodulatory effects.

Objectives: To compare the incidence of infections in statin users to that in nonusers within the same health care system.

Methods: This was a retrospective cohort study of patients enrolled as Tricare Prime or Plus in the San Antonio military multimarket.