Intraabdominal guidewire-related perforation of the esophagus: An uncommon complication of esophageal bougienage treated by intraprocedural clip closure.

Esophageal perforation is an uncommon, though typical complication of esophageal bougienage. However, guidewire-related transmural injury distant from the stricture has only rarely been reported. Post-procedural endoscopy is critical to appreciate perforation and proved instrumental in a unique clinical case with immediate clip closure.

Silence by the LAMS: Primary lumen-apposing metal stent for a colorectal anastomotic stricture .

Lumen-opposing metal stents (LAMS) are evolving as novel treatment options in postsurgical strictues. Data on lower GI tract applications, however, are still limited, and technical procedural details need to be refined. This singular clinical report adds to the emerging experience in colorectal stricture treatment by LAMS.

Upfront endoscopic band ligation for symptomatic gastric angioectasias to reduce peri-endoscopic complexity with an automated implantable cardioverter defibrillator in situ.

Argon plasma coagulation (APC) remains the mainstay endoscopic treatment of gastrointestinal angioectasia. Vis-a-vis automated implanted cardioverter defibrillators (AICD) endoscopic band ligation (EBL) represents an alternative without need for heart-rhythm specialty support.

An unexpected flush of translucent bile in prepapillary stone impaction and the gallbladder .

- translucent, formerly referred to as "white bile," is devoid of bilirubin and bile acids due to a lacking gallbladder in continuity. - traditionally attributed to malignant obstruction, rarely acute stone impaction may underlie a clear bile aspect.

Ultra-delayed post-FTRD resection bleeding.

Non-exposed endoscopic full-thickness resection (EFTR) has gained much momentum in streamlining the treatment of difficult-to-resect colorectal lesions. As a reiteration of the over-the-scope clip (OTSC) platform device-assisted EFTR combines resection with defect closure, thus perforation and/or bleeding are uncommon complications.

Acute biliary pancreatitis caught in the act.

Endoscopic ultrasound is instrumental in biliary pancreatitis for stratifying patients for invasive ERCP, given high rates of spontaneous stone passage. This is reflected in this report illustrating "triple detection" of stones above, at, and below the papilla.

Crowned dens syndrome.

Crowned dens syndrome (CDS) is rare, though likely underdiagnosed, typically presenting with fever, neck pain, and stiffness. Adequate clinical awareness may streamline diagnostics and therapeutics and avoid the need for invasive procedures.

Noninvasive monitoring of liver fat during treatment with GLP-1 analogues and SGLT-2 inhibitors in a real-world setting.

Introduction: Patients with NAFLD have a two-fold increased risk of diabetes, and conversely, NAFLD affects up to 80% of patients with type 2 diabetes. Due to the co-occurrence of both diseases and the lack of approved pharmacotherapy for NAFLD, the anti-steatogenic potential of diabetes-related drugs is being explored. In this study, we aim to monitor liver fat noninvasively during treatment with SGLT-2 inhibitors or GLP-1 analogues in a real-world setting.

Liver Phenotypes of European Adults Heterozygous or Homozygous for Pi∗Z Variant of AAT (Pi∗MZ vs Pi∗ZZ genotype) and Noncarriers.

Background & Aims: Homozygosity for the Pi∗Z variant of the gene that encodes the alpha-1 antitrypsin peptide (AAT), called the Pi∗ZZ genotype, causes a liver and lung disease called alpha-1 antitrypsin deficiency. Heterozygosity (the Pi∗MZ genotype) is a risk factor for cirrhosis in individuals with liver disease. Up to 4% of Europeans have the Pi∗MZ genotype; we compared features of adults with and without Pi∗MZ genotype among persons without preexisting liver disease.

Primary Sclerosing Cholangitis With Features of Autoimmune Hepatitis: Exploring the Global Variation in Management.

Patients with primary sclerosing cholangitis (PSC) frequently manifest features of autoimmune hepatitis (AIH). We sought to understand factors affecting expert management, with the goal of facilitating uniformity of care. A Survey Monkey questionnaire with four hypothetical cases suggesting a potential AIH/PSC variant was sent to hepatologists spanning global practices.

Hidden papilla and periampullary diverticulum: Curtain up for stacked folds.

Proper identification of the Vaterian papilla is a vital prerequisite for success in endoscopic retrograde cholangiopancreatography. Overall, a "" situation is uncommon, often attributable to, for example, intradiverticular localizations in a setting of periampullary diverticulum. Stacked duodenal folds precluding proper endoscopic visualization of the papilla is less well discussed, with virtually no systematic data available.

Hepatic steatosis in patients with acromegaly.

Objective: Comorbid NAFLD is increasingly being diagnosed in patients with diabetes and nondiabetic endocrinopathies. The aim of this study was to assess hepatic steatosis noninvasively by transient elastography in patients with acromegaly.

Design: A cross-sectional study including 22 patients with acromegaly.

Endoscopic shielding using oxidized regenerated cellulose after argon plasma coagulation under mandatory dual antiplatelet therapy.

Endoscopic shielding is an innovative concept in therapeutic endoscopy. Its usage has been mostly restricted to wide-field endoscopic mucosal resection and/or endoscopic submucosal dissection. A novel potential clinical use may be in bleeding pophylaxis for argon plasma coagulation-related ulcers under concomitant mandatory dual antiplatelet therapy.

Extracellular Vesicles in Liver Diseases: Meeting Report from the International Liver Congress 2018.

Extracellular vesicles (EVs) are small and heterogeneous membrane-bound structures released by cells and found in all biological fluids. They are effective intercellular communicators, acting on a number of close and/or distant target cells. EV cargo may reflect the cell of origin as well as the specific stress that induces their formation and release.

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Gastrointestinal stromal tumors (GIST) tumors are a rare, though typical cause for upper GI bleeding. Excavated ulcerated lesions are common; however, a clear-cut visualization of the tumor surface ("") itself has not yet been reported. In line, careful biopsy taking streamlines the diagnostic work-up by providing pathologic diagnosis.

Can genetic testing guide the therapy of cholestatic pruritus? A case of benign recurrent intrahepatic cholestasis type 2 with severe nasobiliary drainage-refractory itch.

Benign recurrent intrahepatic cholestasis (BRIC) is a peculiar familial disease caused by mutations of the genes encoding hepatocanalicular flippase for phosphatidylserine (ATP8B1; BRIC type 1) or the bile salt export pump (ABCB11; BRIC type 2). Here, we report on a patient with nasobiliary drainage-refractory BRIC type 2 who improved under plasma separation and anion absorption therapy. We also suggest that nasobiliary drainage might be an ineffective approach in carriers of severe loss-of-function mutations of the bile salt export pump ABCB11.