Innovative Water-Wire Cannulation Technique for Managing Near-Complete Obstruction Due to Post-orthotopic Liver Transplant Anastomotic Strictures: A Report of Two Cases.

This report presents an innovative water-wire cannulation technique for managing challenging anastomotic strictures in post-orthotopic liver transplant patients, highlighting its successful application in two distinct cases. Anastomotic strictures pose a significant hurdle in hepatobiliary medicine, often complicating the course post-liver transplantation. Standard endoscopic retrograde cholangiopancreatography (ERCP) methods frequently encounter limitations in severe stricture cases, necessitating alternative approaches.

Prevalence and Risk Factors of Choledocholithiasis in Omani Patients With Sickle Cell Disease Undergoing Endoscopic Retrograde Cholangiopancreatography: A Retrospective Analysis.

Background Sickle cell disease (SCD) is a prevalent genetic disorder in the Middle East, particularly in Oman, leading to significant morbidity. It is caused by a mutation in the gene encoding hemoglobin (Hb) molecules, resulting in the formation and polymerization of hemoglobin S (HbS), which subsequently leads to hemolysis. Chronic hemolysis in SCD patients often results in various complications, including increased bilirubin levels in the gallbladder and the formation of pigmented biliary stones, which may obstruct the biliary tract system.

Mucinous Cystic Neoplasm of the Pancreas in Pregnancy: A Case Report.

Mucinous cystic neoplasms (MCNs) of the pancreas are rare epithelial neoplasms, characterized by an inner epithelial layer and an ovarian-type sub-epithelial stroma. These lesions are typically benign but can pose challenges during pregnancy due to their rapid growth potential, associated risk of malignant transformation, and complications such as pancreatitis. We present a case of a 39-year-old pregnant female with a history of recurrent acute pancreatitis, diagnosed with an MCN during pregnancy.

A Novel Technique Using Ryle's Tube for Colonic Decompression in Acute Colonic Pseudo-Obstruction.

Acute colonic pseudo-obstruction, also known as Ogilvie's syndrome, involves colon dilation without mechanical obstruction. It is conventionally treated with conservative measures such as fasting, nasogastric and rectal tube placement, correction of fluids and electrolytes, and, if necessary, use of neostigmine and colonic decompression through colonoscopy. Surgical intervention may be considered in severe cases.

Pneumoperitoneum After Jejunostomy Tube Placement Managed by Needle Decompression: A Case Report.

Percutaneous endoscopic feeding tube placement is a commonly performed procedure in patients who cannot take food by mouth. While it is considered a safe and effective method of providing nutritional support, like any medical procedure, it can lead to complications. Feeding tube placement, including percutaneous endoscopic jejunostomy (PEJ), is associated with several complications, including bleeding, site infection, aspiration, buried bumper, tube dislodgement, and pneumoperitoneum.

An Incidental Finding of Suppurative Appendicitis During Colonoscopy.

Colonoscopic diagnosis of acute appendicitis is extremely rare. Although a few appendicitis cases were reported in literature following colonoscopy, we present a case today of a patient who underwent elective colonoscopy for colorectal cancer screening. The presence of an inflamed appendiceal orifice with projecting pus was documented, and the patient was referred to the surgical team for intervention.

Main-Duct Intraductal Papillary Mucinous Neoplasm Complicated by a Pancreaticogastric Fistula and a Pancreaticocholedocal Fistula.

Intraductal papillary mucinous neoplasms (IPMNs) of the pancreas are a spectrum of benign to malignant epithelial neoplasms that are characterized by papillary proliferation, duct dilation, and cyst formation. A rare complication of IPMNs is fistula formation into adjacent organs such as the duodenum, biliary system, and stomach. Here, we report a case of IPMN with a pancreaticobiliary fistula and pancreaticogastric fistula.

Periampullary Clot Causing Biliary Obstruction: A Rare Presentation.

Acute cholangitis is an emergency condition that requires an emergency biliary drainage for source control of the infection. Commonly cholangitis is precipitated by biliary obstruction due to causes like stones, strictures, stents, or malignancy of the pancreaticobiliary or ampullary origin. We report a unique case of a man who had acute cholangitis due to a periampullary clot who was fully recovered after clot removal by endoscopic retrograde cholangiopancreatography (ERCP).

Treatment With Endoscopic Ultrasound (EUS)-Guided Transesophageal Coil Embolization Without Sclerotherapy: A Novel Therapy for Giant Distal Esophageal Hemangioma.

Giant esophageal hemangiomas are rare. The extent is usually in the mediastinum but may spread down to the upper abdomen. Such vascular pathology is hard to treat and typically to be resected along with the organs it is attached to.

Discharge against Medical Advice among Children in Oman: A university hospital experience.

Objectives: Discharge against medical advice (DAMA) is a major problem in healthcare delivery as it can complicate the health problems from which patients are suffering. The aim of this study was to understand DAMA among children in a tertiary teaching hospital in Oman and to evaluate the documentation of the events in the medical records.

Methods: A retrospective survey of the medical records of patients discharged against medical advice over a two-year interval was performed (2004-2006).