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VideoGIE Image Quiz

  1. PNET and microwave

    A 72-year-old woman is diagnosed with a 3-cm pancreatic neuroendocrine tumor. She is a poor surgical candidate, given her comorbid conditions. Using EUS guidance, the patient undergoes novel microwave ablation of the tumor. There is encouraging radiologic response at 4-week follow-up. Your GI fellow asks you the difference between radiofrequency ablation (RFA) and microwave ablation. Which of the following is the most accurate statement regarding RFA?
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  2. Rolling stones

    A 51-year-old man with recurrent pyogenic cholangitis presents with right upper quadrant abdominal pain, elevated bilirubin, and dilated bile ducts. MRCP demonstrates multiple large intraductal filling defects. An EUS-guided hepaticogastrostomy is performed, and several stones and stone fragments are extracted by balloon catheter. Which of the following statements is the most accurate?
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  3. An esophageal ultrasound

    A 50-year-old man with schistosomiasis-induced liver fibrosis presented with melena. He underwent EGD, which showed large, high-risk varices. He underwent sclerotherapy for initial treatment. Follow-up endoscopy with subsequent EUS was performed. What is the next best step in management?
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  4. A manometric mystery

    This high-resolution esophageal manometry is classic for what GI finding or diagnosis?
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  5. A pancreatitis problem

    A 16-year-old boy with history of distal bile duct resection with Roux-en-Y hepaticojejunostomy for a choledochal cyst presented with recurrent pancreatitis. Diagnostic imaging with MRCP was completed, and subsequently ERCP was recommended. A cholangioscopy image is shown. What is the most likely cause of his recurrent pancreatitis?
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  6. A special stain

    A 51-year-old man was referred for assessment of an esophageal lesion as shown. Based on the imaging with white light, optical enhancement, and Lugol’s staining, what is the most likely diagnosis?
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  7. This lesion is out of place

    A 26-year-old man with chronic epigastric abdominal pain presents for upper endoscopy. A 2-cm subepithelial lesion is noted in the gastric antrum. ESD is performed using the assistance of a novel traction device. Histopathology reveals ectopic pancreas with chronic inflammation and fibrosis. Which of the following is true of ectopic pancreas?
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  8. An interesting obstruction

    A 55-year-old woman presents with chronic right-upper quadrant abdominal pain, nausea, vomiting, and anorexia. Liver enzymes and alkaline phosphatase are elevated with normal bilirubin. MRCP reveals a dilated common bile duct with a linear filling defect. A 20-cm worm is extracted during a challenging ERCP with EUS rendezvous. Which of the following is true of Ascaris lumbricoides infection?
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  9. Making the correct diagnosis

    A 77-year-old man with multiple comorbidities presents with obstructive jaundice and a mass in the head of the pancreas. He undergoes EUS, and findings are suggestive of autoimmune pancreatitis (AIP). Which of the following is the most accurate statement regarding AIP?
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  10. An alternate port of entry

    A 49-year-old man with a history of mucinous adenocarcinoma of the urinary bladder and stage IV adenocarcinoma of the sigmoid colon presents with colonic obstruction. He previously had overlapping metal stents placed in the distal colon with inadequate stent expansion. The patient undergoes a percutaneous colostomy via lumen apposing metal stent for palliation. Which of the following statements is the most accurate?
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