Flexible endoscopic diverticulotomies for bilateral Zenker's Diverticula (with videos).

Objectives/hypothesis: Zenker's diverticulum (ZD) is the posterior pulsion diverticulum below the esophageal introitus through or above the cricopharyngeal muscle. We report a unique case of bilateral ZD that was successfully treated with an endoscopic diverticulotomies on the bilateral cricopharyngeal bars.

Study Design: Case report at a tertiary referral center.

Acute pancreatitis during pregnancy.

Background & Aims: Acute pancreatitis is rare during pregnancy; limited data are available about maternal and fetal outcomes. We investigated the effects of acute pancreatitis during pregnancy on fetal outcome.

Methods: This retrospective cohort study, performed at a single academic center, included consecutive pregnant women who presented with (n = 96) or developed acute pancreatitis in the hospital (n = 7) in 2000-2006 (mean age, 26 y).

Management of transmesenteric tunnel jejunal strictures with endoscopic dilation by using achalasia balloons (with videos).

Background: Roux-en-Y gastric bypass is the most commonly performed bariatric operation in the United States. Transmesenteric tunnel (TMT) or mesocolic jejunal stricture is an unusual postoperative complication that requires another operation. We hypothesize that endoscopic dilation by using achalasia dilatation balloons can be used to treat some TMT jejunal strictures.

Endotherapy for severe and complete pharyngo-esophageal post-radiation stenosis using wires, balloons and pharyngo-esophageal puncture (PEP) (with videos).

Background: Pharyngo-esophageal stenosis (PES) and upper esophageal stricture are common in patients who receive radiation therapy for laryngeal and hypopharyngeal cancers. In severe or complete stenosis, the patients generally have complete dysphagia with inability to swallow their saliva. Diagnostic and therapeutic esophagogastroduodenoscopy (EGD) plays an important role in investigating the dysphagia and in managing the underlying stenosis.

Endotherapy for a 5-cm mid-esophageal perforation with tandem stenting above the lower esophageal sphincter (with videos).

Background: Esophageal perforation, whether spontaneous or more commonly as a result of instrumentation, is a life-threatening condition and carries high mortality despite recent advances. Outcome is dependent on etiology, location of injury, and interval between perforation and initiation of therapy. Successful management of esophageal perforation entails combination of: (1) control of the leakage site either surgically or endoscopically to prevent further contamination, (2) drainage of contamination, and (3) appropriate antibiotics along with nutritional support.

Acute ischemic stroke: Not a moment to lose.

Familiarize yourself with recommendations from the latest stroke care guidelines so you'll be prepared to respond within the narrow therapeutic window for optimal treatment.

Endoscopic hemostasis in nonvariceal upper gastrointestinal bleeding: comparison of physician practice in the East and the West.

Background: Endoscopic hemostasis is commonly practiced during GI endoscopy practice. We hypothesized that, because the choice of endoscopic intervention is influenced by many factors, for example personal experience, prior training, guidelines, etc., there would be differences in practice patterns among different groups of endoscopists.