Gastroenterological endoscopy 3rd Edition by Michael Wallace, Paul Fockens, Joseph Jao Yiu Sung ISBN 9783132578937 3132578932

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ISBN 10: 3132578932
ISBN 13: 9783132578937
Author: Michael B. Wallace, Paul Fockens, Joseph Jao-Yiu Sung

Highly Commended by the BMA Medical Book Awards for Internal Medicine!

Written and edited by internationally renowned specialists, the third edition of Gastroenterological Endoscopy covers the entire spectrum of diagnostic and therapeutic procedures for the upper and lower GI tract while providing the latest overview of GI disorders. A great wealth of high-resolution photographs provides the visual information needed to confidently assess and diagnose mucosal lesions of the entire digestive tract. Significant advances in the field—both medical and technical—since the last edition are covered in comprehensive detail.

Key Features:

• New panel of top international editors, continuing the tradition of excellence, depth, and breadth as originated by founding editors Classen, Tytgat, and Lightdale; list of contributing authors is a “who’s who” of GI endoscopy
• Coverage of newest, advanced tools and techniques: gastric-POEMS, submucosal tunnel endoscopic resection (STER), lumen-apposing metal stents, “over-the-scope” clips, and much more
• More than 750 exquisite images

Gastroenterological Endoscopy, third edition, surely deserves a prominent place in any complete endoscopy reference collection.

Gastroenterological endoscopy 3rd Edition Table of contents:

I Introduction to Endoscopy

1 Education and Training in Endoscopy

1.1 Introduction

1.2 Clinical Education

1.2.1 Clinical Training to Competency in Esophagogastroduodenoscopy and Colonoscopy: Studies, Guidelines, and Assessment

1.2.2 Training in Endoscopic Retrograde Cholangiopancreatography

1.2.3 Complementary E-learning and Video Courses

1.3 Incorporation of Simulators in Training

1.4 Endoscopy Simulators and Training Models

1.4.1 Plastic Phantoms and Other Static Models

1.4.2. Computer Simulators

1.4.3 Training Courses with Live Animals

1.4.4 Ex Vivo Porcine Tissue Models (EASIE, Erlanger Endo-Trainer, EASIE-R)

1.4.5 Training Courses

1.4.6 Incorporating Simulator Training into Educational Programs and Maintaining Skills in Complex Procedures

References

2 The Value of Clinical Research

2.1 Introduction

2.2 Keys to Success

2.2.1 A Tough Skin

2.2.2 Building Teams

2.3 Designing Clinical Trials

2.3.1 Generating Ideas

2.3.2 Refining Ideas

2.3.3 Clinical Trial Design

2.3.4 Grant Writing

2.3.5 Conducting Clinical Trials

2.3.6 Presentation and National Meetings

2.3.7 Manuscript Writing

2.4 Ethics

2.4.1 Conflict of Interest

2.4.2 Registration of Clinical Trials and Underreporting of Negative Trials

2.4.3 Falsification of Data

2.4.4 Plagiarism

2.5 Manuscript Submission and Review Process

2.5.1 Expanding the Reach

2.5.2 The Future of Scientific Publications

References

II The Patient and Endoscopy

3 Informed Consent for Gastrointestinal Endoscopy

3.1 Introduction

3.2 What Is “Informed Consent”?

3.3 Clinician and Patient Relationship

3.4 What Information Is Required?

3.5 How Should the Information Be Provided?

3.6 Where and When Should the Consent Be Taken?

3.7 Withdrawal of Consent

3.8 Exceptions to the Requirement of Consent

References

4 Patient Preparation and Sedation for Endoscopy

4.1 Introduction

4.2 Presedation Assessment

4.3 Monitoring during Endoscopic Sedation

4.3.1 Introduction

4.3.2 Hemodynamic Monitoring

4.4 Pharmacology

4.4.1 Introduction

4.4.2 Benzodiazepines

4.4.3 Opioids

4.4.4 Propofol

4.4.5 Who Should Perform Endoscopic Sedation?

4.5 Postprocedure Care

4.5.1 Monitoring during Recovery

4.5.2 Discharge

References

5 Design of the Endoscopy Suite

5.1 Introduction

5.2 General Questions and Considerations

5.3 Guidelines for Planning an Endoscopy Suite

5.4 Pathways for Patients, Staff, and Material

5.5 Location of the Unit

5.6 Number of Rooms

5.7 X-Ray Requirements

5.8 The Endoscopic Examination Room

5.8.1 Size of the Rooms

5.8.2 Equipment

5.8.3 Monitor Systems and Anesthesia

5.8.4 Video Integration and PC-Based Documentation

5.8.5 Endoscopes and Endoscopic Equipment

5.9 Endoscopic Ultrasound and Laser Treatment Room, Radiography Room

5.10 Preparation and Recovery Room

5.11 Cleaning and Disinfection Area

5.12 Staffing

References

6 Cleaning and Disinfection in Endoscopy

6.1 Introduction

6.2 Principles of Disinfection

6.2.1 Definitions

6.2.2 Application to Gastrointestinal Endoscopes

6.2.3 Liquid Chemical Germicides and Automated Endoscope Reprocessors

6.3 Transmission of Infection by Gastrointestinal Endoscopy

6.3.1 Transmission by Endoscopes with Elevators

6.3.2 Failure or Breach in Reprocessing

6.3.3 Unusual Organisms

6.4 Design and Oversight of Reprocessing Facilities

References

7 Electrosurgical Principles for Endoscopy

7.1 Introduction

7.2 Electrosurgical Principles

7.2.1 Electrical and Tissue Variables

7.2.2 Monopolar versus Bipolar Circuit

7.3 Electrosurgical Units and Waveforms

7.4 Practical Applications

7.4.1 Snare Polypectomy

7.4.2 Hot Biopsy

7.4.3 Sphincterotomy

7.4.4 Hemostasis

7.4.5 Miscellaneous

7.5 Electrosurgical Hazards and Safety

7.5.1 Unintended Burn Injury

7.5.2 Implanted Electromagnetic Devices

7.5.3 Bowel Explosion

7.6 Conclusion

References

8 Antibiotic Prophylaxis in Endoscopy

8.1 Introduction

8.2 Bacteremia Related to Endoscopic Procedures

8.2.1 Procedures Associated with Low Risk of Bacteremia

8.2.2 Procedures Associated with High Risk of Bacteremia

8.3 Antibiotic Prophylaxis for the Prevention of Infective Endocarditis

8.3.1 Antibiotic Prophylaxis for the Prevention of Procedural-Related Infections (Other Than IE)

8.4 EUS-FNA

8.5 Percutaneous Endoscopic Gastrostomy/Jejunostomy

8.6 Cirrhosis with GI Bleeding

8.7 Synthetic Vascular Grafts and Other Nonvalvular Cardiovascular Devices

8.8 Orthopaedic Prostheses

8.9 Patients Receiving Peritoneal Dialysis

References

9 Quality Assurance in Endoscopy

9.1 The Importance of Quality

9.2 Performance Measures

9.3 Practicalities of Measurement

9.3.1 Clinical Importance

9.3.2 Standardization

9.3.3 Practicality

9.3.4 Governance Infrastructure

9.3.5 Negative Aspects

9.4 Quality Improvement

9.5 Summary

References

10 Endoscopic Complications

10.1 Introduction

10.2 General Considerations

10.2.1 Cardiopulmonary and Sedation-Related Events

10.2.2 Infection

10.3 Upper Gastrointestinal Endoscopy

10.3.1 Diagnostic Upper Gastrointestinal Endoscopy

10.3.2 Therapeutic Upper Gastrointestinal Endoscopy

10.3.3 Management of Upper Gastrointestinal Perforation

10.3.4 Management of Upper GI Bleeding

10.4 Small Bowel Endoscopy

10.5 Colonoscopy

10.5.1 Perforation

10.5.2 Management of Colonic Perforation

10.5.3 Bleeding

10.5.4 Unusual Complications

10.6 ERCP

10.6.1 Bleeding

10.6.2 Perforation

10.6.3 Infections

10.6.4 Post-ERCP Pancreatitis

10.7 Other Techniques

10.7.1 EUS-Guided Celiac Block/Neurolysis

10.7.2 EUS-Guided Drainage of Pancreatic Fluid Collections

10.7.3 Peroral Endoscopic Myotomy

10.8 Conclusion

10.9 Key Points

References

11 Anticoagulation and Endoscopy

11.1 Introduction

11.2 Antithrombotics

11.2.1 Antiplatelet Agents

11.2.2 Anticoagulants Agents

References

III General Diagnostic and Therapeutic Procedures and Techniques

12 Upper Gastrointestinal Endoscopy

12.1 History of Upper Gastrointestinal Endoscopy

12.2 General Diagnostic Techniques

12.2.1 Indications

12.2.2 Contraindications

12.3 Preparation of the Patient

12.4 Sedation

12.5 Use of Antifoaming Agents and Antispasmotics

12.6 Procedural Steps for Upper Gastrointestinal Endoscopy

12.6.1 Insertion and Observation

12.6.2 Esophagus

12.6.3 Esophagogastric Junction

12.6.4 Stomach and Duodenum

12.6.5 Transnasal Upper Endoscopy

12.7 Common Pathologies for Upper Gastrointestinal Endoscopy

12.7.1 I: Upper Gastrointestinal Cancers

12.7.2 II: Upper Gastrointestinal Hemorrhage

12.7.3 III: GERD and Barrett’s Esophagus

12.8 Screening for BE

12.9 Surveillance for BE

12.10 Barrett’s Esophagus–Related Dysplasia

12.11 Complications of Upper Gastrointestinal Endoscopy

References

13 Enteroscopy Techniques

13.1 Introduction

13.2 Overview of Enteroscopy Procedures

13.2.1 Anatomical Characteristics of the Small Intestine

13.2.2 Classification and Principles of Device-Assisted Enteroscopy

13.2.3 Balloon-Assisted Enteroscopy (Double-Balloon Endoscopy/Single-Balloon Endoscopy)

13.2.4 Spiral Endoscopy

13.3 General Diagnostic Techniques

13.4 General Therapeutic Techniques

13.4.1 Hemostasis

13.4.2 Balloon Dilation

13.4.3 Polypectomy/Endoscopic Mucosal Resection

13.4.4 Retrieval of Foreign Bodies

13.5 Accessory Devices and Techniques

13.6 Indications for the Use of Device-Assisted Enteroscopy

13.6.1 Indications for Diagnostic Use

13.6.2 Indications for Follow-Up of Small Intestinal Lesions

13.6.3 Therapeutic Indications for Device-Assisted Enteroscopy

13.6.4 Miscellaneous Indications for Device-Assisted Enteroscopy

13.7 Procedure-Specific Quality Measures

13.8 Procedure-Specific Training Requirements

13.8.1 Minimizing Air Insufflation for Deep Intubation

13.8.2 Necessity of X-Ray Fluoroscopy during Device-Assisted Enteroscopy

13.9 Minimizing Procedure-Specific Complications

13.9.1 Complications of Balloon-Assisted Endoscopy

13.9.2 Complications of Spiral Endoscopy

13.10 Conclusions

References

14 Wireless Video Capsule Endoscopy

14.1 Introduction

14.2 Technology

14.3 Setting and Preparation for Video Capsule Endoscopy

14.4 VCE Administration

14.5 Indications for VCE

14.6 Contraindications to VCE

14.7 Risk of VCE Retention

14.8 Reading a VCE Study

14.9 Conclusion

References

15 Colonoscopy: Preparation, Instrumentation, and Technique

15.1 Introduction

15.2 Preparation

15.2.1 Indications and Contraindications

15.2.2 Patient Preparation

15.3 Basic Instrumentation

15.3.1 Sedation

15.3.2 Colonoscope

15.3.3 Accessories

15.4 Technique

15.4.1 Scope Insertion

15.4.2 Scope Withdrawal

15.4.3 Polypectomy

15.4.4 Complications

15.5 Quality Measures

References

16 Endoscopic Retrograde Cholangiopancreatography

16.1 Introduction

16.2 Overview of Procedure

16.3 General Diagnostic Techniques

16.3.1 Biliary Cannulation

16.3.2 Sphincter of Oddi Manometry

16.4 General Therapeutic Techniques

16.4.1 Biliary Sphincterotomy

16.4.2 Endoscopic Papillary Balloon Dilation

16.4.3 Stone Extraction

16.4.4 Biliary Stenting

16.5 Accessory Devices and Techniques

16.5.1 Endoscopes

16.5.2 Equipment

16.6 Accepted Indications

16.7 Procedure-Specific Quality Measures

16.8 Procedure-Specific Training Requirements

16.9 Procedure-Specific Complications

References

17 Cholangioscopy

17.1 Introduction

17.2 Overview of Cholangioscopy

17.3 General Diagnostic Techniques

17.3.1 Two-Operator Systems: Mother-Baby Scopes

17.3.2 Single-Operator System: SpyGlass Cholangiopancreatoscopy

17.3.3 Direct Cholangioscopy

17.4 Accessory Devices and Techniques

17.4.1 Confocal Microscopy

17.4.2 Lithotripsy Probes

17.4.3 Intraductal Biopsy Forceps

17.5 Accepted Indications

17.5.1 Evaluation of Indeterminate and Malignant Biliary Strictures

17.5.2 Diagnosis and Management of Choledocholithiasis

17.5.3 Photodynamic Therapy of Cholangiocarcinoma

17.6 Complications of Cholangioscopy

References

18 Advanced Imaging Methods

18.1 Introduction

18.2 High-Definition Endoscopes

18.3 Virtual Chromoendoscopy

18.4 Narrow-Band Imaging

18.5 Flexible Spectral Imaging Color Enhancement

18.6 i-Scan and Optical Enhancement

18.7 Clinical Application of Virtual Chromoendoscopy

18.8 Chromoendoscopy

18.9 Clinical Application of Chromoendoscopy

18.10 Confocal Laser Endomicroscopy

18.11 Probe-Based CLE

18.12 Endoscope-Based CLE

18.13 Clinical Application

18.14 Optical Coherence Tomography

18.15 Conclusions

References

19 The Contribution of Histopathology to Endoscopy

19.1 Prerequisites

19.2 Clinical Impact of Histopathology by Segment within the Gastrointestinal Tract

19.2.1 Esophagus

19.2.2 Stomach

19.2.3 Small Bowel

19.2.4 Colorectum

19.3 Endoscopic Resections

19.4 Conclusion

References

20 Endoscopic Ultrasonography

20.1 Introduction

20.2 Overview of the Procedure

20.3 General Diagnostic and Therapeutic Techniques

20.3.1 Conditions of Implementation

20.3.2 Endoscopes and Probe

20.3.3 EUS Semiology of the Bowel Wall

20.3.4 Techniques

20.4 Accessory Devices and Techniques

20.4.1 Elastography

20.4.2 Contrast-Enhanced EUS

20.4.3 Needles and EUS-Guided Sample

20.5 Accepted Indications

20.6 Quality Measures

20.7 Training

20.8 Complications and Prevention

20.8.1 Noninterventional EUS

20.8.2 EUS-FNA

20.8.3 Interventional EUS

20.9 Prevention

References

21 Hybrid, Natural Orifice, and Laparoscopy-Assisted Endoscopy: New Paradigms in Minimally Invasive Therapy

21.1 Introduction

21.2 History of NOTES

21.3 Submucosal Surgery

21.4 Back to NOTES

21.5 Laparoscopy-Assisted Endoscopy

21.6 Laparoscopy-Assisted Endoscopic Resection

21.7 Endoscopy-Assisted Laparoscopic Resection

21.8 Combined Laparoscopic–Endoscopic Resection

21.9 Summary

References

IV Upper Gastrointestinal Tract Disease

22 Gastroesophageal Reflux Disease and Infectious Esophagitis

22.1 Diagnostic Approaches

22.2 Therapeutic Approaches

22.3 Surgical Therapy

22.4 Endoscopic Therapy for GERD

22.5 Infectious Esophagitis

22.5.1 Candida Esophagitis

22.5.2 Herpes Simplex Virus Esophagitis

22.5.3 Cytomegalovirus Esophagitis

22.5.4 Other Infections

References

23 Barrett’s Esophagus and Early Neoplasia

23.1 Diagnostic Work-Up for Barrett’s Esophagus and Early Neoplasia

23.1.1 General Approach to Barrett’s Esophagus

23.1.2 Endoscopic Imaging of Barrett’s Esophagus

23.2 Endoscopic Surveillance for Barrett’s Esophagus

23.3 Management of Dysplasia and Early Cancer in Barrett’s Esophagus

23.3.1 Indications for Endoscopic Treatment

23.3.2 Endoscopic Treatment Techniques

23.3.3 Current Guidelines for Endoscopic Treatment and Subsequent Follow-Up

23.4 Areas of Uncertainty, Experimental Techniques, and Research

23.4.1 Biological Markers in Barrett’s Esophagus

23.4.2 Low-Risk Submucosal Cancer

23.4.3 Novel Developments in Endoscopic Ablation

23.5 Conclusion

References

24 Squamous Neoplasia of the Esophagus

24.1 Introduction

24.1.1 Epidemiology and Risk Factors

24.1.2 Precursor Lesions for Squamous Neoplasia

24.2 Diagnostic Approaches

24.2.1 Nonendoscopic Techniques

24.2.2 Endoscopic Techniques

24.3 Treatment for Squamous Neoplasia of the Esophagus

24.3.1 Endoscopic Resection

24.4 Thermal Therapy

24.4.1 Radiofrequency Ablation

24.4.2 Cryotherapy

24.4.3 Other Ablative Techniques

24.5 Areas of Uncertainty, Experimental Techniques, and Research

24.6 Summary

References

25 Benign Esophageal Strictures and Esophageal Narrowing Including Eosinophilic Esophagitis

25.1 Introduction

25.2 Diagnostic Approaches

25.2.1 General Approach Including Causes, Symptoms, and Diagnosis

25.3 Classification System

25.4 Therapeutic Approaches

25.4.1 Standard Technique

25.4.2 Variations of Standard Techniques

25.5 Novel Diseases Causing Esophageal Stricturing

25.5.1 Eosinophilic Esophagitis

25.6 Post–Endoscopic Resection

25.7 Areas of Uncertainty, Experimental Techniques, and Research

References

26 Achalasia

26.1 Introduction

26.1.1 Epidemiology

26.1.2 Pathophysiology

26.1.3 Etiology

26.1.4 Clinical Presentation

26.2 Diagnostic Approaches

26.2.1 General Approach Including Equipment and Techniques

26.2.2 Achalasia Subtypes

26.2.3 Guidelines and Systematic Reviews

26.3 Therapeutic Approaches

26.3.1 Standard Techniques

26.3.2 Guidelines and Systematic Reviews

26.4 Areas of Uncertainty, Experimental Techniques, and Research

References

27 Advanced Esophageal Cancer

27.1 Introduction

27.2 Diagnosis and Classification

27.2.1 Malignant Dysphagia

27.2.2 Stents

27.2.3 Cryotherapy

27.2.4 Feeding Tubes

27.2.5 Esophagorespiratory Fistulas

27.2.6 Stents

27.2.7 Clips

27.2.8 Sutures

27.2.9 Bleeding

27.3 Conclusion

References

28 Peptic Ulcer Disease and Bleeding, Including Duodenal Ulcer

28.1 Introduction

28.2 Diagnosis of Peptic Ulcer Disease and Bleeding

28.3 Choice of Instrument for Peptic Ulcer Bleeding

28.4 Therapeutic Modalities for Peptic Ulcer Bleeding

28.4.1 Injection Therapy

28.4.2 Thermal

28.4.3 Mechanical Therapy

28.4.4 Topical Hemostatic Powders

28.5 New Hemostatic Modalities

28.5.1 Endoscopic Suturing

28.5.2 Endoscopic Ultrasound–Guided Angiotherapy

28.6 Conclusion

Reference

29 Gastric Cancer Including Early Neoplasia and Preneoplastic Conditions

29.1 Introduction

29.2 Diagnostic Approach

29.2.1 Preparation

29.2.2 Endoscopic Technique

29.2.3 Knowledge for Diagnosis

29.3 Therapeutic Approach

29.3.1 Principle of Endoscopic Resection

29.3.2 Indication for Endoscopic Resection

29.3.3 Clinical Management after Endoscopic Resection

29.4 Future Prospects

29.5 Repeat as Needed for Each Condition

References

30 Obesity: Endoscopic Approaches

30.1 Introduction

30.2 Obesity: Endoscopic Approaches

30.3 Diagnostic Approach and the Multidisciplinary Obesity Center Concept

30.3.1 General Approach, Equipment, and Techniques

30.3.2 Therapeutic Approaches: Currently Available Techniques

30.3.3 Gastric Techniques

30.3.4 Small Bowel Techniques

30.3.5 Endoscopic Revision of Prior Gastric Bypass

30.3.6 Other Postoperative Issues That Lead to Weight Gain and May Require Endoscopic Intervention

30.3.7 Guidelines and Systematic Reviews

30.3.8 Experimental Techniques

30.4 Summary

References

31 Small Intestinal Diseases Beyond the Duodenum

31.1 Introduction

31.2 Suspected Small Bowel Bleeding

31.2.1 Diagnostic Approaches

31.2.2 Therapeutic Approaches

31.3 Small Bowel Crohn’s Disease

31.3.1 Diagnosis

31.3.2 Therapeutics

31.4 Dilation of Small Bowel Stricture

31.5 Small Bowel Tumors

31.5.1 Diagnosis

31.5.2 Therapeutics

31.6 Malabsorption Disorders of the Small Bowel

31.6.1 Diagnostics and Therapeutics

31.7 Small Intestinal Infections

31.8 Congenital Lesions

31.9 Miscellaneous Conditions

31.10 Conclusion

References

32 Sporadic Neoplastic Polyps of the Duodenum and Ampulla

32.1 Introduction

32.2 Ampullary Neoplastic Polyps

32.2.1 Types of Ampullary Polyps

32.2.2 Clinical Manifestations

32.2.3 Diagnosis

32.2.4 Management of Ampullary Neoplasms

32.2.5 Endoscopic Ampullectomy

32.2.6 Endoscopic Outcomes: Clinical Success, Recurrence Rates

32.2.7 Surveillance

32.3 Conclusion

32.4 Nonampullary Sporadic Neoplastic Duodenal Polyps

32.4.1 Types of Nonampullary Duodenal Polyps

32.4.2 Diagnosis

32.4.3 Management of Nonampullary Duodenal Adenomas

32.4.4 Outcomes of Endoscopic Mucosal Resection

32.4.5 Adverse Events

32.4.6 Post–Endoscopic Mucosal Resection Care

32.4.7 Role of Endoscopic Submucosal Dissection

32.4.8 Surveillance

32.5 Conclusion

References

33 Malabsorption and Food Allergy/Intolerance

33.1 Introduction

33.2 Standard Endoscopy

33.2.1 Water-Immersion Technique

33.3 Chromoendoscopy and Magnification Endoscopy

33.4 Narrow-Band Imaging

33.5 Confocal Laser Endomicroscopy

33.6 Optical Coherence Tomography

33.7 Device-Assisted Enteroscopy

33.7.1 Capsule Endoscopy

33.8 Selected Small Bowel Diseases

33.8.1 Celiac Disease

33.8.2 Tropical Sprue

33.8.3 Small Bowel Bacterial Overgrowth

33.8.4 Sprue-Like Enteropathy Associated with Olmesartan

33.9 Conclusion

References

34 Portal Hypertension, Varices, Gastropathy, and Gastric Antral Vascular Ectasia

34.1 Introduction

34.2 Portal Hypertension: What Do We Need to Know?

34.2.1 Pathophysiology of Portal Hypertension

34.2.2 Noncirrhotic Portal Hypertension

34.2.3 Cirrhotic Portal Hypertension: Natural History, Risk Stratification, and Individualizing Care

34.3 Diagnosis of Portal Hypertension

34.3.1 Hepatic Venous Pressure Gradient

34.3.2 Noninvasive Tests

34.4 Treatment of Portal Hypertension

34.4.1 Primary Prophylaxis

34.4.2 Management of Acute Variceal Bleeding

34.5 Secondary Prophylaxis

34.6 Management of Treatment Failure

34.7 New Modality in Management of AVB: Hemospray

34.8 Management of Gastric Varices

34.9 Management of Ectopic Varices

34.10 Portal Hypertensive Gastropathy and Gastric Antral Vascular Ectasia

34.11 Areas of Uncertainty, Experimental Techniques, and Research

34.12 Conclusion

References

V Lower Gastrointestinal Tract Disease

35 Colorectal Polyps and Cancer Screening/Prevention

35.1 Introduction

35.2 Polyp Classification and Polyp Cancer Sequences

35.3 Conventional Adenomas

35.3.1 Low-Risk versus Advanced Conventional Adenomas

35.3.2 Shape and Colonic Distribution of Conventional Adenomas

35.3.3 Surface Features of Conventional Adenomas

35.3.4 Resection of Conventional Adenomas

35.4 Serrated Class Lesions

35.4.1 Terminology and Histology

35.4.2 Endoscopic Presentation

35.4.3 Resection of Serrated Lesions

35.5 Colorectal Cancer Screening

35.5.1 Approaches to Offering Screening

35.5.2 Factors That Affect Colorectal Cancer Risk

35.5.3 Choices of Individual Screening Tests

35.5.4 Surveillance after Cancer Resection

35.6 Conclusion

References

36 Advanced Colorectal Polyps and Early Cancer Resection

36.1 Introduction

36.2 Technical Aspects and Preparation

36.2.1 Patient Preparations

36.2.2 Techniques of Endoscopic Resection

36.2.3 Equipment Required

36.3 Lesion Assessment

36.4 Resection Technique

36.4.1 Endoscopic Mucosal Resection

36.4.2 Endoscopic Submucosal Dissection

36.5 Unique Situations

36.5.1 EMR of LSLs at the Anorectal Junction

36.5.2 EMR of LSLs at the Ileocecal Valve

36.5.3 EMR of Circumferential LSLs

36.5.4 EMR of Lumen Filling Lesions

36.5.5 EMR of Periappendiceal LSLs

36.5.6 EMR of Multiple Recurrent LSLs

36.5.7 Sessile Serrated Lesions

36.5.8 Endoscopic Resection of Large Pedunculated Lesions

36.6 Endoscopy versus Surgery

36.7 Complications

36.7.1 Intraprocedural Bleeding

36.7.2 Clinically Significant Postendoscopic Bleeding

36.7.3 Deep Injury

36.7.4 Postprocedural Pain

36.8 Residual and Recurrent Disease

36.8.1 Recurrence and EMR

36.8.2 Techniques at the Initial EMR to Prevent Recurrence

36.8.3 Triaging Patients to Follow Up Based on Risk of Recurrence

36.8.4 Accurate Assessment of the Post-EMR Scar

36.8.5 Endoscopic Treatment of Post-EMR Recurrence

36.9 Future Direction of ER

References

37 Inheritable Cancer Syndromes

37.1 Introduction

37.2 Nonpolyposis Syndromes

37.2.1 Lynch’s syndrome

37.2.2 Familial CRC

37.3 Polyposis Syndromes

37.3.1 Familial Adenomatous Polyposis

37.3.2 Attenuated Familial Adenomatous Polyposis

37.3.3 MUTYH-Associated polyposis

37.3.4 Serrated Polyposis Syndrome

37.3.5 Hamartomatous Polyposis Syndromes

References

38 Inflammatory Bowel Disease and Microscopic Colitis

38.1 Introduction

38.2 Endoscopic Characteristics of IBD

38.2.1 Lower Endoscopy

38.2.2 Upper Endoscopy

38.2.3 Small Bowel Imaging

38.2.4 Endoscopic Ultrasonography

38.2.5 Endoscopic Retrograde Cholangiopancreatography

38.3 Endoscopy in Established IBD

38.3.1 Acute Colitis

38.3.2 Routine Endoscopy

38.4 Endoscopic Evaluation of IBD Disease Activity

38.4.1 Crohn’s Disease

38.4.2 Ulcerative Colitis

38.5 Endoscopy after Surgery

38.5.1 Lower Endoscopy

38.6 Endoscopic Surveillance in IBD

38.7 Therapeutic Endoscopic Approaches in IBD

38.8 Microscopic Colitis

References

39 Lower Intestinal Bleeding Disorders

39.1 Introduction

39.2 General Aspects

39.2.1 Epidemiology

39.2.2 Clinical Course and Prognosis

39.3 Diagnostic Approach

39.3.1 History

39.3.2 Physical Examination

39.3.3 Laboratory Studies

39.3.4 Endoscopy

39.3.5 Nonendoscopic Methods

39.4 Differential Diagnosis

39.4.1 Diverticula

39.4.2 Vascular Diseases

39.4.3 Inflammation

39.4.4 Neoplasia

39.4.5 Anorectal Diseases

39.5 Therapy

39.5.1 Initial Resuscitation

39.5.2 Endoscopy

39.6 Injection Therapy

39.7 Thermocoagulation

39.8 Topical Agents

39.8.1 Hemospray (Cook Medical) TG 325

39.8.2 EndoClot (EndoClot Plus Inc.)

39.8.3 Ankaferd Blood Stopper (Ankaferd Health Products)

39.9 Mechanical Methods

39.9.1 Over-the-scope Clip System (OTSC) (Ovesco, Tübingen, Germany)

39.10 Differential Endoscopic Therapy

39.10.1 Diverticula

39.10.2 Vascular Diseases

39.10.3 Inflammation

39.10.4 Neoplasia

39.10.5 Bleeding after Colonic Polypectomy

References

40 Anorectal Diseases

40.1 Introduction

40.2 Inflammation

40.2.1 Crohn’s Disease

40.2.2 Perianal Abscesses

40.2.3 Anorectal Fistula

40.3 Infection

40.3.1 Chlamydial Infection

40.3.2 Gonococcal Proctitis

40.3.3 Herpes Simplex Virus

40.3.4 Syphilis

40.3.5 Lymphogranuloma Venereum

40.4 Vascular Cause

40.4.1 Ischemic Proctitis

40.4.2 Radiation Proctitis

40.5 Neoplasm

40.5.1 Anal Cancer

40.5.2 Anal Intraepithelial Neoplasia

40.6 Mechanical Cause

40.6.1 Hemorrhoids

40.6.2 Rectal Prolapse

40.6.3 Solitary Rectal Ulcer Syndrome

40.6.4 Anal Fissure

40.6.5 Stercoral Ulcer

References

VI Biliopancreatic, Hepatic, and Peritoneal Diseases

41 Benign Biliary Disorders

41.1 Introduction

41.2 Postoperative Biliary Stricture

41.3 Chronic Pancreatitis and Biliary Strictures

41.4 Primary Sclerosing Cholangitis

41.5 Bile Duct Leaks

References

42 Malignant Biliary Disease

42.1 Introduction

42.2 Diagnostic Approach

42.2.1 Radiologic Imaging

42.2.2 Endoscopic Retrograde Cholangiopancreatography

42.2.3 Fluorescence In-Situ Hybridization

42.2.4 Cholangioscopy

42.2.5 Endoscopic Ultrasound-Fine Needle Aspiration

42.2.6 Intraductal Ultrasound

42.2.7 Probe-based Confocal Laser Endomicroscopy

42.3 Classification Systems

42.4 Guidelines and Systematic Reviews

42.5 Therapeutic Approaches

42.5.1 Standard Techniques

42.5.2 Liver Transplantation

42.5.3 Variation of Standard Techniques

42.6 Guidelines and Reviews

42.7 Areas of Uncertainty

References

43 Acute and Chronic Pancreatitis

43.1 Introduction

43.2 Diagnostic Approaches

43.2.1 Overview

43.2.2 Equipment and Techniques

43.2.3 Guidelines and Systematic Reviews

43.3 Therapeutic Approaches

43.3.1 Standard Techniques

43.3.2 Guidelines and Systemic Reviews

43.4 Areas of Uncertainty, Experimental Techniques, and Research

43.4.1 Diagnostic Procedures

43.4.2 Therapeutic Procedures

43.5 Conclusion

References

44 Pancreatic Cancers and Cystic Neoplasms

44.1 Introduction

44.2 Pancreatic Cancers

44.2.1 Ductal Adenocarcinoma of the Pancreas

44.2.2 Pancreatic Neuroendocrine Tumors

44.3 Cystic Lesions of Pancreas

44.3.1 Nonneoplastic Cysts

44.3.2 Pancreatic Cystic Neoplasms

References

45 Subepithelial Tumors of the Gastrointestinal Tract

45.1 Introduction

45.2 Types of SETs

45.2.1 Gastrointestinal Stromal Tumors

45.2.2 Leiomyomas

45.2.3 Carcinoids

45.2.4 Other Subepithelial Lesions of the Gastrointestinal Tract

45.3 Risk Stratification of Subepithelial Tumors

45.4 Methods for Tissue Acquisition

45.4.1 Endoscopic Ultrasound-Guided Fine-Needle Aspiration

45.4.2 Endoscopic Ultrasound-Guided Fine-Needle Biopsy and Trucut Biopsy

45.4.3 Other Tissue Acquisition Techniques

45.5 Management of Subepithelial Lesions

45.6 Endoscopic Resection of Subepithelial Tumors

References

46 Gastrointestinal Foreign Bodies

46.1 Introduction

46.2 Clinical Epidemiology

46.2.1 Overview of Pathophysiology

46.3 Patient Presentation

46.4 Diagnosis

46.4.1 Treatment

46.4.2 Pharmacologic therapies

46.4.3 Endoscopic accessories and interventions

46.4.4 Esophageal food impaction

46.4.5 Sharp foreign bodies

46.4.6 Coins and button batteries

46.4.7 Bezoars

46.4.8 Rectal foreign bodies

46.5 Complications

46.6 Conclusion and Future Trends

References

Index

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