ASGE Endoscopy Live: Pancreatobiliary Cases and Updates (virtual)

Video Transcription

Video Summary

In this video, doctors discuss the case of an 88-year-old female who presented with postprandial abdominal pain and elevated liver enzymes. The patient had a history of rheumatoid arthritis and prior cholecystectomy. MRCP showed dilated intra and extrahepatic bile ducts, but no evidence of obstruction. Endoscopic retrograde cholangiopancreatography (ERCP) was attempted but unsuccessful due to a large perianfilary diverticulum. The patient also had symptoms of intermittent postprandial nausea, vomiting, abdominal distention, and weight loss. The doctors discuss the possible causes of the patient's symptoms, including obstructive processes and sphincter of Oddi dysfunction. They decide to perform EUS guided interventions and ERCP to further evaluate the small intestine and biliary system. The video shows an echoendoscope being used to access the bile ducts transhepatically, followed by a cholangiogram. The doctors discuss the findings and plans for further treatment, including the possibility of placing a fully covered hypo-gastric stent. The video provides a valuable insight into the diagnostic and therapeutic approach to biliary obstruction.

Asset Subtitle

Mouen Khashab, MD

Keywords

abdominal pain

liver enzymes

cholecystectomy

bile ducts

obstruction

ERCP