ERCP catheter or dilator? Which is best for fistula dilation following guidewire placement in EUS-guided transhepatic biliary drainage?

Objectives: EUS-guided biliary drainage (EUS-BD) is performed after endoscopic transpapillary biliary drainage fails. Although fistula dilation is one of the most difficult steps of EUS-BD, whether an ultratapered ERCP catheter or a dilator is the best choice for fistula dilation is unclear. In this study, we aimed to identify the optimal device for fistula dilation after guidewire placement.

[Intestinal malrotation accompanied by a right paraduodenal hernia in an adult: a case report].

A 72-year-old woman was admitted to our department in March 2020 for an evaluation of nausea, vomiting, diarrhea, liver dysfunction, and hypokalemia, which had persisted intermittently since 2013. Thickening of the descending duodenal wall and a sac-like appearance the intestinal tract in the vicinity of the duodenal papilla were observed in abdominal computed tomography. No duodenojejunal curvature, with two intestinal loops identified in the descending region, was detected in contrast-enhanced upper gastrointestinal imaging.