Showing papers in "Gastrointestinal Endoscopy Clinics of North America in 2012"

TL;DR: This review describes seminal findings in each of the 3 domains of the pathogenesis of celiac disease, namely genetics, environmental triggers, and immune dysregulation, with a focus on newer areas of investigation such as non-HLA genetic variants, the intestinal microbiome, and the role of the innate immune system.

TL;DR: Understanding of complications of ERCP has progressed substantially in the past decade, including widespread adoption of standardized consensus-based definitions of complications, large multicenter multivariate studies that have permitted clearer understanding of patient and technique-related risk factors for complications, and introduction of new technical approaches to minimize risks.

TL;DR: The term non-celiac gluten sensitivity (NCGS) has been suggested for this condition, although a role for gluten proteins as the sole trigger of the associated symptoms remains to be established.

TL;DR: This review summarizes key aspects regarding the histopathologic assessment, impact of the site and number of small bowel biopsy samples on diagnosis, old and emerging classifications, and benefit of standardized pathology report in the diagnostic workup of CD.

TL;DR: The mode of presentation of patients with celiac disease has changed dramatically over the recent decades, with diarrheal or classic presentations becoming less common; this trend is most markedly seen in children, whose main presentations include recurrent abdominal pain, growth issues, and screening groups at risk.

TL;DR: The evidence of the protective effect of a gluten-free diet (GFD) on mortality and malignancy in celiac disease is examined and there is some evidence suggesting that a GFD may reduce the risk of lymphoproliferative malignancies.

TL;DR: Issues related to identifying the appropriate patient to test for celiac disease, the performance characteristics of serologic testing, the role of gene testing for human leukocyte antigen DQ2 and DQ8 haplotypes, and issues related to the performance of small intestinal biopsy are reviewed.

TL;DR: A number of the key technical aspects of endoscopic ultrasound-guided-fine-needle aspiration of solid pancreatic masses are addressed.

TL;DR: In developing countries the adherence to the treatment is still difficult because of poor availability of dedicated gluten-free food, and few studies have addressed atypical or silent CD.

TL;DR: Newer endoscopic techniques such as endoscopic ultrasound, cholangioscopy, confocal endomicroscopy, and metal biliary stenting are increasingly complementing traditional ERCP techniques in achieving long-term sustained stricture resolution.

TL;DR: The indications, techniques, and outcomes of published data on EUS-HG are described, which include internal drainage, thus avoiding long-term external drainage in cases where external PTBD drainage catheters cannot be internalized.

TL;DR: The gluten-free diet is currently the only treatment for celiac disease, and patients should be monitored closely by a dietitian who is knowledgeable regarding this diet.

TL;DR: With the introduction of curvilinear endosonoscopes, endoscopic ultrasonography has achieved the role of a therapeutic modality as well as diagnostic procedure and various techniques of EUS-guided tumor ablation have been described.

TL;DR: The connection between IBS and CD and the new concept of nonceliac gluten sensitivity (NCGS) is discussed and it is suggested that some patients with IBS without CD may derive symptomatic benefit from a gluten-free diet.

TL;DR: CH-EUS can be used to identify the target for EUS-guided FNA by clearly depicting the outline of the lesions and compliment EUS fine-needle aspiration (FNA) in identifying malignant tumors.

TL;DR: It is established that EUS-RV is a feasible and safe technique and should be considered as an alternative to percutaneous or surgical approaches for failed biliary cannulation.

TL;DR: The clinical and pathologic features of RCD and recent pathogenic findings in RCDII are reviewed, offering a model to study how inflammation can drive T-cell lymphomagenesis.

TL;DR: In this chapter, the indications, techniques and clinical algorithm for EUS-guided pseudocyst drainage and pancreaticogastrostomy are reviewed.

TL;DR: There is uncertainty regarding the efficacy and role of CN in managing pancreatic cancer pain, but CN should still be considered in this difficult-to-treat cohort of patients.

TL;DR: The gastrointestinal tract provides a unique window to access vascular structures in the mediastinum and abdomen, and interventional endoscopic ultrasound (EUS) has enabled access to these structures with standard fine-needle aspiration.

TL;DR: The nature of subepithelial lesions is discussed, focusing on the most recent developments that use endoscopic ultrasonography to diagnose and manage these lesions.

TL;DR: Based on the current understanding of celiac disease pathogenesis, several potential targets of therapeutic intervention exist and these novel strategies provide promise of alternative, adjunctive treatment options but also raise important questions regarding safety, efficacy, and monitoring of long-term treatment effect.

TL;DR: The pickup rate of CD has improved with the availability of serologic tests, and this has led to a reduction in morbidity in treated CD cases.

TL;DR: Ability to characterize pancreatic cystic lesions has improved, although accuracy is often still lacking, and future work with molecular analysis of cyst fluid, direct cystoscopy, and confocal laser endomicroscopy will likely enhance the diagnostic accuracy of these lesions.

TL;DR: This article reviews recent literature regarding the safety and efficacy of EUS-guided fiducial markers and brachytherapy and discusses novel concepts, including E US-guided celiac ganglia radiation neurolysis.

TL;DR: Endoscopic ultrasound (EUS) is a minimally invasive but highly effective technique that enables internal drainage of the abscess and evidence supporting its clinical efficacy is increasing rapidly.

TL;DR: These intertwining elements of ERCP, using optimal techniques in an ideal environment and a well-trained team, conscious of the risks and the ways to minimize them, are discussed.

TL;DR: The theoretical aspects and the methodology of EUS elastography are reviewed and clinical applications, mainly in pancreatic diseases and lymph nodes, are analyzed.

TL;DR: Endoscopic ultrasound-guided pancreatic cyst ablation with ethanol and/or paclitaxel offers a nonoperative treatment for patients refusing or not eligible for surgery, with variable degrees of cyst epithelial ablation.

TL;DR: The authors like to consider this area of integration or overlap of endoscopic procedures within the practice of hepatology as endo-hepatology.