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Balloon enteroscopy-assisted ERCP (BE-ERCP) has become the first-line therapy for biliopancreatic anastomotic strictures. However, it is not always successful, and salvage methods have not been established. This study aimed to evaluate the outcomes of EUS-guided transanastomotic drainage using a forward-viewing (FV) echoendoscope.

Of eight cases wherein BE-ERCP treatment failed due to severe or complete benign anastomotic stricture, seven cases underwent EUS-guided choledochojejunostomy, and EUS-guided pancreaticojejunostomy was applied in one case after intubating an FV echoendoscope into the anastomotic site.

The success rate of reaching the target site was 100% (8/8) for patients after modified Child resection. The median time to reach the anastomosis was 5 min (range 3-17 min), and the technical success rate for drainage was 75% (6/8). The median total procedure time was 33.5 min (range 22-45 min) for six successful cases. Cautery dilatation catheters were necessary to dilate the puncture site in all cases, and no early complications were observed. During the follow-up period (median 13.3 months [range 6.5-60.3]), recurrence of the stricture occurred in one case, and a stent-free status was achieved after 6-12 months of stent placement in five cases.

EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.

EUS-guided transanastomotic drainage using an FV echoendoscope is a feasible and safe rescue technique for the management of benign severe biliopancreatic anastomotic strictures.

We initially reported EUS-guided lauromacrogol ablation (EUS-LA) to treat pancreatic cystic neoplasms (PCNs); however, its long-term effectiveness remains unknown. This study was performed to further determine the effectiveness of EUS-LA in a larger population with a long-term follow-up based on 5 years of experience with EUS-LA.

From April 2015 to April 2020, 279 patients suspected of having PCNs were prospectively enrolled, and seventy patients underwent EUS-guided ablation using lauromacrogol alone. Fifty-five patients underwent follow-up, 35 of whom had a follow-up duration of at least 12 months. The effectiveness of ablation was determined based on volume changes.

Among the fifty female and twenty male patients with an overall mean age of 50.3 years, cysts were located in the head/neck of the pancreas in 37 patients (52.9%) and in the body/tail of the pancreas in 33 patients (47.1%). The adverse events rate was 3.6% (3/84), with 14 patients undergoing a second ablation. Among the 55 patients who underwent follow-up, the median cystic volume sharply decreased from 11,494.0 mm

to 523.6 mm

(P < 0.001), and the mean diameter decreased from 32.0 mm to 11.0 mm (P < 0.001). Postoperative imaging showed complete resolution (CR) in 26 patients (47.3%) and partial resolution (PR) in 15 (27.3%) patients. CR was observed in 18 (51.4%), and PR was observed in 9 (25.7%) patients among the 35 patients followed for at least 12 months.

EUS-LA was effective and safe for the treatment of PCNs with stable effectiveness based on at least 12 months of follow-up.

EUS-LA was effective and safe for the treatment of PCNs with stable effectiveness based on at least 12 months of follow-up.Trauma remains the leading cause of death in individuals less than 45 years. Management of major trauma is protocol driven around the world. Most protocols are in line with the popular Advanced Trauma Life Support (ATLS) principles. These principles have been adjudged to be safe and consistent even in the presence of infectious diseases while employing standard precautions. In view of the current community spread, large cases of COVID 19 in the Federal Capital Territory (FCT) and the magnitude of the infectivity, it has become necessary to adjust our local trauma resuscitation protocols in order to ensure the safety of the trauma team and the trauma patients as well.Phyllodes tumors are uncommon breast neoplasms that constitute of 1-2% of breast malignancies. The tumor can mimic fibroadenoma clinically, radiologically and histologically. Ductal carcinoma in-situ in the epithelial component of phyllodes tumor is very rare. When ductal carcinoma in-situ is detected within the specimen, the management of treatment changes completely. We report a rare case of low grade ductal carcinoma in-situ arising in a malignant phyllodes tumor in a 55-year-old female patient.Peritonitis is a common and serious complication of peritoneal dialysis and often primary factor of change over to hemodialysis treatment. Raoultella planticola is known as as environmental bacterium and rarely causes infections in humans. selleck compound We present a case of peritoneal dialysis related peritonitis due to Raoultella planticola and review the clinical manifestations and treatment options of this microorganism. As far as we know, this is the third case of Raoultella planticola peritonitis in the literature.

We aimed to evaluate the findings of whole-body computed tomography (WBCT) in pediatric high-energy trauma patients and to determine the distribution of injuries.

The WBCT images of 1132 pediatric patients who were admitted to emergency department between 2013 and 2018 for high-energy trauma were evaluated retrospectively. Six hundred and twenty patients with abdominal, chest, head, and skeletal injuries were included.

Using the WBCT images, we detected skeletal injuries in 557 pediatric patients; spinal, rib, extremity, and pelvic fractures were detected in 113, 57, 51, and 37 patients, respectively. Craniofacial fractures were viewed in 299 patients. We detected intracranial hemorrhage, pulmonary contusion, pneumothorax, and solid organ injuries in 102, 115, 45, and 55 pediatric patients, respectively.

The frequency and distribution of injuries in trauma cases vary between adults and children. While there are many studies about whole-body CT findings of adult trauma, there are only a few studies about pediatric high-energy trauma patients. The traumatic injury types also differ in pediatric age groups. WBCT scan (with pediatric radiation dose) is the fast and accurate diagnostic tool in high-energy trauma cases and therefore is associated with low mortality rates.

The frequency and distribution of injuries in trauma cases vary between adults and children. While there are many studies about whole-body CT findings of adult trauma, there are only a few studies about pediatric high-energy trauma patients. The traumatic injury types also differ in pediatric age groups. WBCT scan (with pediatric radiation dose) is the fast and accurate diagnostic tool in high-energy trauma cases and therefore is associated with low mortality rates.