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Insulinoma With Ambiguous Biochemistry, Positive Ga-DOTA-Exendin-4 PET-CT, and Effective Endoscopic Ablation.
JCEM Case Rep
January 2025
Department of Endocrinology, Tan Tock Seng Hospital, Singapore 308433.
A 75-year-old female presented with fasting hypoglycemic episodes. A supervised fast ended at 72 hours fulfilling Whipple triad, with suppressed insulin and C-peptide levels, but discordantly suppressed serum β-hydroxybutyrate levels. After 21 months of recurring symptoms, a repeat fast ended at 48 hours with Whipple triad, suppressed serum β-hydroxybutyrate level, and borderline nonsuppressed C-peptide level, suggesting endogenous hyperinsulinism.
View Article and Find Full Text PDFTraction-assisted endoscopic ultrasound-guided fine-needle biopsy using the clip-with-thread method for small gastric subepithelial lesions: Randomized controlled trial (with video).
Dig Endosc
January 2025
Department of Medicine and Bioregulatory Science, Graduate School of Medical Sciences, Kyushu University, Fukuoka, Japan.
Objectives: Endoscopic ultrasound-guided fine-needle aspiration/biopsy (EUS-FNA/B) is the gold standard for diagnosing gastric subepithelial lesions (SELs), but diagnosing lesions smaller than 20 mm remains challenging. We developed traction-assisted EUS-FNB (TA-EUS-FNB) using the clip-with-thread method to enhance diagnostic accuracy by stabilizing the lesion and providing counter-traction for easier needle access. This study evaluates the effectiveness of TA-EUS-FNB in diagnosing small gastric SELs.
View Article and Find Full Text PDFOutcomes of endoscopic ultrasound-guided transmural drainage for postoperative peripancreatic fluid collection with an external drainage-based approach.
BMC Gastroenterol
January 2025
Division of Gastroenterology, Department of Internal Medicine, Showa University Fujigaoka Hospital, Yokohama, Kanagawa, Japan.
Background: Endoscopic ultrasound-guided transmural drainage (EUS-TD) is widely performed to treat postoperative peripancreatic fluid collection (POPFC). Recent reports on EUS-TD lack a consensus on stent selection. This study aimed to assess the efficacy of EUS-TD for POPFC using an external drainage-based approach.
View Article and Find Full Text PDFJaundice as the onset of paracoccidioidomycosis.
Rev Esp Enferm Dig
January 2025
Digestive Medicine, Hospital Clinico Universitario de Valencia .
We report the case of a 24-year-old man from Brazil presenting with jaundice and epigastric pain. Abdominal CT and endoscopic ultrasound (EUS) revealed a mass in the pancreatic-duodenal groove, intrahepatic duct dilation, and lymphadenopathy, initially suggestive of lymphoproliferative syndrome. However, cytopathological analysis of EUS-guided fine needle aspiration (EUS-FNA) of the lymph nodes confirmed paracoccidioidomycosis.
View Article and Find Full Text PDFDiagnostic modalities in the mediastinum and the role of bronchoscopy in mediastinal assessment: a narrative review.
Mediastinum
December 2024
Division of Pulmonary, Critical Care and Sleep Medicine, University of California San Diego, San Diego, CA, USA.
Background And Objective: Diagnosis of pathology in the mediastinum has proven quite challenging, given the wide variability of both benign and malignant diseases that affect a diverse array of structures. This complexity has led to the development of many different non-invasive and invasive diagnostic modalities. Historically, diagnosis of the mediastinum has relied on different imaging modalities such as chest X-ray, computed tomography (CT), magnetic resonance imaging, and positron emission topography.
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