ASGE International Sampler (On-Demand)-ENDO HANGOUTS for GI Fellows: Luminal EUS Part II

Video Transcription

Video Summary

The video is a recording of a presentation called "Luminal EUS Part 2" in the ASG Endo Hangout with GI Fellows. The presentation begins with introductions and housekeeping items. The doctors discuss three cases during the presentation. The first case involves a 43-year-old female with abdominal pain, where the doctors recommend an endoscopic ultrasound (EUS) and fine needle aspiration (FNA) for diagnosis. The second case features an 81-year-old woman with back and right upper quadrant pain, weight loss, and obstructive jaundice, where the doctors discuss the possibility of adenocarcinoma and the importance of examining the portal vein for signs of involvement. The third case involves a 68-year-old patient with a cystic lesion, where the doctors discuss the differential diagnosis and criteria for further intervention or surveillance. <br /><br />The presenters mention that biopsy results for an intraductal papillary mucinous neoplasm (IPMN) did not significantly change their approach, as they would have taken a fluid sample to confirm if it was mucinous regardless. They emphasize the importance of individualizing patient care and using guidelines as a general basis for decision-making. The use of molecular analysis and confocal microscopy as diagnostic tools for pancreatic cysts is discussed. The significance of elevated carcinoembryonic antigen (CEA) levels in cyst fluid analysis is also mentioned, with recommendations to take various factors into account when evaluating CEA levels. The use of antibiotics during pancreatic cyst aspiration and the potential risks of infection are discussed, with recent studies showing no significant difference in infection rates between those who receive antibiotics and those who do not. The importance of proper colon prep during rectal fine needle aspirations (FNA) to prevent stool contamination is highlighted, along with the use of touch prep slides for on-site cytology assessment. The presentation briefly touches on autoimmune pancreatitis and the importance of considering it as a differential diagnosis in certain cases. Overall, the video provides insights into the diagnosis and management of pancreatic cysts, emphasizing individualized patient care and the use of various diagnostic tools.

Asset Subtitle

Amitabh Chak, MD, MS, FASGE; Ashley Faulx, MD, FASGE; Vanessa Shami, MD, FASGE; Girish Mishra, MD, MSc, FASGE; GI Fellow Moderators: Paula Adamson, MD; Jordan Orr, MD

Keywords

Luminal EUS Part 2

ASG Endo Hangout

GI Fellows

endoscopic ultrasound

fine needle aspiration

adenocarcinoma

pancreatic cysts

differential diagnosis

CEA levels

antibiotics

colon prep

autoimmune pancreatitis