We present the case of a patient with severe complications from mediastinal bleeding after endosonographically guided transbronchial cryobiopsy (EBUS-TBKB) with suspected advanced lymphoma. The EBUS-TBKB is a new effective examination method in interventional pneumology for the diagnosis of diseases with mediastinal lymph node enlargement and intrathoracic tumors, with which large tissue cylinders in the mediastinum can be obtained. Due to the high diagnostic value of endobronchial ultrasound-guided transbronchial needle aspiration (EBUS-TBNA) for the clarification of lymphadenopathy, the examination should not be carried out as a routine application. Indications for a primary EBUS-TBKB arise when there is a suspicion of intrathoracic malignant lymphomas or other rare tumors in which extensive unfragmented tissue material is required for diagnosis. A rare complication that has not yet been described in the literature is a hematomediastinum, so that a careful risk assessment of possible bleeding complications should be carried out before intervention and the more invasive mediastinoscopy can be a safer examination method.
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http://dx.doi.org/10.1055/a-2002-4972 | DOI Listing |
J Clin Med
December 2024
Department of General, Abdominal, Vascular and Transplant Surgery, Otto-von-Guericke University with University Hospital, Leipziger Str. 44, 39120 Magdeburg, Germany.
: Drawing upon over twenty years of clinical experience in endoscopic and endosonographic procedures, along with comprehensive literature research, we present an overview on EUS-guided pancreatography and pancreatic duct drainage (EUS-PD) as an alternative approach, encompassing indications, procedural methods, and outcomes, including complications and the success rate. Narrative review. (corner points): EUS-PD is indicated for cases, for which conventional methods are ineffective due to altered abdominal anatomy of the upper gastrointestinal (GI) tract, such as congenital or postoperative conditions that prevent access to the papilla or pancreatoenteric anastomosis.
View Article and Find Full Text PDFClin Endosc
December 2024
Department of Internal Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan.
Background/aims: Endoscopic ultrasound-guided fine needle biopsy (EUS-FNB) is an essential tool for tissue acquisition in solid pancreatic tumors. Rapid on-site evaluation (ROSE) by cytologists ensures diagnostic accuracy. However, the universal application of the ROSE is limited by its availability.
View Article and Find Full Text PDFTurk J Gastroenterol
November 2024
Department of Gastroenterology, Ankara University Faculty of Medicine, Ankara, Türkiye.
Background/aims: Radiological imaging advancements have led to a rise in pancreatic cyst diagnoses. Apart from imaging modalities, endoscopic ultrasonography (EUS) is an important method in the diagnosis of pancreatic cysts. The aim of this study is to determine the clinical, laboratory, biochemical, radiological, and endosonographic features of pancreatic cysts and to assess the effectiveness of EUS and computed tomography (CT) in differentiating between neoplastic and nonneoplastic cysts.
View Article and Find Full Text PDFMedicina (Kaunas)
October 2024
Division of Gastroenterology and Digestive Endoscopy, Humanitas Research Hospital-IRCCS, Rozzano, 20089 Milano, Italy.
: Subepithelial lesions (SELs) of the gastrointestinal (GI) tract present a diagnostic challenge due to their heterogeneous nature and varied clinical manifestations. Usually, SELs are small and asymptomatic; generally discovered during routine endoscopy or radiological examinations. Currently, endoscopic ultrasound (EUS) is the best tool to characterize gastric SELs.
View Article and Find Full Text PDFDig Dis Sci
November 2024
Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, No.138, Sheng Li Road, Tainan, 704, Taiwan.
Background: Endoscopic ultrasound-guided fine-needle biopsy (EUS-FNB) is highly accurate for diagnosing pancreatic mass. However, making diagnosis is challenging in 5-20% of patients. This study investigated the challenging features associated with reduced diagnostic performance in EUS-FNB and potential rescue methods that can improve the diagnostic rate.
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