Comparative evaluation of transpapillary drainage with nasopancreatic drain and stent in patients with large pseudocysts located near tail of pancreas.

Background: Endoscopic transpapillary drainage is usually not advocated for large pseudocysts for fear of infection. We compared efficacy of transpapillary drainage with nasopancreatic drain (NPD) or stent alone in large pseudocysts (>6 cm) located near tail of pancreas.

Methods: In a prospective study, a 5-Fr stent/NPD was placed across/near pancreatic duct disruption in 11 patients (nine chronic and two acute pancreatitis) with large pseudocysts located near tail of pancreas.

Endoscopic transpapillary drainage for external fistulas developing after surgical or radiological pancreatic interventions.

Background And Aims: External pancreatic fistulas (EPFs) are a therapeutic challenge. The present study was conducted to evaluate the efficacy of endoscopic transpapillary nasopancreatic drainage (NPD) in patients with EPF.

Methods: Over 12 years, 23 patients (19 males) with EPF underwent attempted endoscopic transpapillary NPD.

Endoscopic management of pancreatic pseudocysts at atypical locations.

Background And Aims: There is paucity of data on endoscopic management of pseudocysts at atypical locations. We evaluated the efficacy of endoscopic transpapillary nasopancreatic drain (NPD) placement in the management of pseudocysts of pancreas at atypical locations.

Patients And Methods: Eleven patients with pseudocysts at atypical locations were treated with attempted endoscopic transpapillary nasopancreatic drainage.

Endoscopic examination of the upper esophagus by withdrawal of endoscope over guide wire.

Upper gastrointestinal (UGI) endoscopy is an important diagnostic modality in evaluation of patients with upper gastrointestinal (GI) disorders. However, lesions located in the cricopharyngeal area and upper esophagus can be missed, as this area may not be well visualized during endoscopy. This study was conducted to study the utility of a new technique of endoscopic examination of the upper esophagus by withdrawal of endoscope over guide wire in diagnosing esophageal disorders.

Parasitic infestations of the biliary tract.

Parasitic infestations of the biliary tract are a common cause of biliary obstruction in tropical countries and can lead to such serious complications as cholangitis and cholangiocarcinoma. Endoscopic therapy has helped in the management of biliary complications caused by these parasites. Ascaris lumbricoides organisms, which normally reside in the jejunum, are actively motile and can invade the papilla, thus migrating into the bile duct and causing biliary obstruction.

Ansa pancreatica type of ductal anatomy in a patient with idiopathic acute pancreatitis.

Context: Ansa pancreatica is a type of pancreatic ductal variation. The exact clinical significance of this ductal variation is not clear.

Case Report: We report the case of a 21-year-old male with acute idiopathic severe pancreatitis and extensive parenchymal necrosis who later developed a large pancreatic abscess.

An intra-hepatic pancreatic pseudocyst successfully treated endoscopic transpapillary drainage alone.

Context: An intra-hepatic pseudocyst is a very rare complication of acute and chronic pancreatitis with less than thirty cases described in the literature. Successful resolution of intra-hepatic pseudocysts with endoscopic transpapillary nasopancreatic drain placement has not previously been described.

Case Report: We report the case of a 34-year-old male with chronic idiopathic non-calcific pancreatitis, anomalous pancreatobiliary junction and a large intra-hepatic pancreatic pseudocyst along with a large abdominal pseudocyst who was successfully treated by endoscopic transpapillary nasopancreatic drainage alone.

Successful resolution of a mediastinal pseudocyst and pancreatic pleural effusion by endoscopic nasopancreatic drainage.

Context: A mediastinal pseudocyst is an unusual complication of acute and chronic pancreatitis. The ideal form of management is controversial, and various successful therapeutic interventions including surgical resection, internal or external drainage, and non-operative radiological drainage techniques have been described. Successful resolution of a mediastinal pseudocyst with endoscopic transpapillary stent placement has been described in fewer than five cases.

Nonalcoholic steatohepatitis in Asian Indians is neither associated with iron overload nor with HFE gene mutations.

Aim: The pathogenesis of occurrence of liver inflammation and fibrosis in patients with nonalcoholic steatohepatitis (NASH) is not completely understood. Other than insulin resistance, iron abnormalities have been thought to be one of the triggering factors. Therefore, our aim was to study the role of iron abnormalities and HFE gene mutations in patients with NASH.

Prevalence of obesity, diabetes mellitus and hyperlipidaemia in patients with cryptogenic liver cirrhosis.

Non-alcoholic steatohepatitis (NASH) is emerging as an important cause of cryptogenic cirrhosis. Obesity, diabetes mellitus and hyperlipidaemia are important risk factors for NASH. The presence of these risk factors in patients with cryptogenic cirrhosis may suggest NASH as an aetiology of cirrhosis in them.