Practical Pediatric Gastrointestinal Endoscopy

4 Chapter 13Figure 13.1 (a) GIT biopsies embedded in multicassettes (e.g., ABC). The mac...Figure 13.2 (a) Gastrointestinal sample embedded on edge, rendering a good v...

5 Chapter 14Figure 14.1 Double‐balloon enteroscope system configuration.Figure 14.2 DBE technique.Figure 14.3 Double‐balloon tattoo.Figure 14.4 Polyp detected (a) and removed (b).Figure 14.5 Multiple angiomas in small bowel.Figure 14.6 Meckel’s diverticulum.Figure 14.7 (a) Blue rubber bleb nevus syndrome lesions. (b) Blue rubber ble...Figure 14.8 Single‐balloon enteroscopy.Figure 14.9 Spiral enteroscopy outside the patient.Figure 14.10 Spiral enteroscope advancing intraluminally.Figure 14.11 Extent of laparoscopic‐assisted enteroscopy.Figure 14.12 Intraoperative enteroscopy and transillumination of a discrete ...

6 Chapter 15Figure 15.1 Occult bleeding from an angiodysplasia.Figure 15.2 Jejunal Peutz–Jeghers polyp.Figure 15.3 (a) Crohn’s disease. (b) A follow‐up study in a 16‐year‐old male...Figure 15.4 CMUSE or diaphragm disease.Figure 15.5 Lymphoma.Figure 15.6 Meckel's diverticulum.Figure 15.7 NSAID lesions.Figure 15.8 Crohn’s aphthoid ulcers and stricture.Figure 15.9 Celiac disease.Figure 15.10 Methods of “front‐loading” the PillCam TMonto a gastroscope. (a...Figure 15.11 Intestinal lymphangiectasia.Figure 15.12 Intestinal intussusception.Figure 15.13 Images obtained with an esophageal capsule.Figure 15.14 Colon capsule.Figure 15.15 Mechanism for magnetic capsule propulsion.

7 Chapter 16Figure 16.1 Ultrasound catheter probe.Figure 16.2 Front‐loading ultrasound probe.Figure 16.3 Radial scan ultrasound. Distal tip of echo‐endoscope with balloo...Figure 16.4 Linear scan ultrasound video endoscope. Distal tip of echo‐endos...Figure 16.5 The linear probe with advanced aspiration/biopsy needle.Figure 16.6 EUS of the needle ( double arrow ) advanced into a pancreatic pseu...Figure 16.7 Orientation of a FNA needle advanced through the operative chann...Figure 16.8 (a) Esophagus wall; the first inner hyperechoic (bright) layer i...Figure 16.9 Esophageal anastomotic stenosis: thickening of concentric layers...Figure 16.10 Esophageal duplication marked by arrow.Figure 16.11 Congenital stenosis with aberrant cartilaginous remnants ( white ...Figure 16.12 Gastrointestinal stromal tumor (GIST) (arising from submucosal ...Figure 16.13 GIST‐FNA. Arrow points toward the FNA within the labeled mass (...Figure 16.14 Gastric lymphoma (distortion of the gastric wall and enlarged l...Figure 16.15 Duodenal duplication.Figure 16.16 Plicate hypertrophy of the stomach related to Helicobacter pylo ...Figure 16.17 Duodenal web.Figure 16.18 Choledocholithiasis: two stones ( arrow ) in the dilated common b...Figure 16.19 Autoimmune pancreatitis (white arrow pointing at fullness in pa...Figure 16.20 Pancreatic pseudocyst. (a) Hypoechoic/anechoic cyst ( white arro ...

8 Chapter 17Figure 17.1 The tip of a pediatric ERCP catheter pushed through the biopsy c...Figure 17.2 Endoscopic view of Barrett’s esophagus: (a) plain close view; (b...Figure 17.3 Endoscopic view of the distal duodenum in a patient with celiac ...Figure 17.4 Immersion chromoendoscopy after methylene blue spray, without pr...Figure 17.5 In a patient with familial adenomatous polyposis coli, flat (a) ...Figure 17.6 Colonic polyps before and after chromoendoscopy. (a) Hyperplasti...

9 Chapter 18Figure 18.1 Confocal laser endomicroscope (Pentax).Figure 18.2 Comparison of confocal images with conventional histological ima...Figure 18.3 Comparison of confocal images with conventional histological ima...Figure 18.4 (a) Inflammatory bowel disease showing bifid crypt pattern, cryp...Figure 18.5 CLE of GVHD showing nuclear debris representing apoptotic bodies...

10 Chapter 20Figure 20.1 Friability, edema, and erythema of varying degrees eventually as...Figure 20.2 Endoscopic characteristics of herpes esophagitis including mucos...Figure 20.3 Similar characteristics are shown in this figure.Figure 20.4 In epidermolysis bullosa, narrowing of the esophagus is more pro...Figure 20.5 Crohn’s esophageal involvement is usually with aphthoid ulcerati...Figure 20.6 Radiation‐ or chemotherapy‐induced esophagitis can be significan...

11 Chapter 21Figure 21.1 Exudate – whitish coating on the esophageal surface. Exudate rep...Figure 21.2 Circumferential rings along the length of the esophagus. This fi...Figure 21.3 Mucosal edema and linear furrows. These finding are representati...Figure 21.4 Longitudinal rent. This split can occur with the passage of the ...Figure 21.5 Food impaction present in the esophageal lumen. Mucosa is edemat...

12 Chapter 23Figure 23.1 (a) Endoscopy with water immersion showing normal villus pattern...Figure 23.2 (a) Duodenal biopsy specimen with bottom opened and oriented on ...

13 Chapter 25Figure 25.1 Complex esophageal stricture secondary to caustic ingestion.Figure 25.2 Congenital esophageal stenosis with tracheal remnants.Figure 25.3 (a) Fluoroscopic appearance of a balloon waist. The arrow shows ...Figure 25.4 Incisions of the scar performed using a needle knife and a cutti...Figure 25.5 Two‐year‐old boy with complex esophageal stricture due to causti...Figure 25.6 The Dynamic Stent®.Figure 25.7 (a) The Dynamic Stent® in correct position. The two radiopaque b...

14 Chapter 26Figure 26.1 Grade I corrosive esophagitis with diffuse erythema and minimal ...Figure 26.2 Grade IIa corrosive esophagitis: extensive mucosal sloughing.Figure 26.3 Grade IIb of corrosive esophagitis: multiple ulcerations.Figure 26.4 Corrosive gastritis.Figure 26.5 Esophageal stricture after lye ingestion.Figure 26.6 Multiple esophageal strictures two months after caustic ingestio...

15 Chapter 27Figure 27.1 Subtypes of achalasia on high‐resolution manometry: (a) I, (b) I...Figure 27.2 Diagnosis and treatment algorithm based on expert opinion and cu...Figure 27.3 Rigiflex dilator.Figure 27.4 Submucosal injection of methylene blue prior to mucosotomy.Figure 27.5 Lineal mucosal incision.Figure 27.6 Initial stage of tunnel development.Figure 27.7 Creation of a tunnel using an electrical knife and pressure from...Figure 27.8 Completion of the tunnel with exposed circular muscle.

16 Chapter 28Figure 28.1 EndoCinch front‐mounted on the endoscope.Figure 28.2 Suction applied and full‐thickness tissue capture followed by ne...Figure 28.3 Endoscopic gastroplication. This figure shows the pattern of a z...Figure 28.4 View (J manoeuver) of a lax GE junction in a child with major re...Figure 28.5 EndoCinch pediatric series pH efficacy at one year.Figure 28.6 Significant improvement in the total QOLRAD score one and three ...Figure 28.7 The Full‐Thickness Plicator.Figure 28.8 Application of the Full‐Thickness Plicator.Figure 28.9 Retroverted views of stages of application of the Full‐Thickness...Figure 28.10 Distal end of the EsophyX device (a) and SerosaFuse fastener (b...Figure 28.11 Endoscopic images of gastroesophageal valves from two subjects ...Figure 28.12 Operation times comparing endoscopic, laparoscopic. and open fu...Figure 29.13 Hospital stay (days) comparing endoscopic, laparoscopic, and op...Figure 28.14 Total cost comparing endoscopic, laparoscopic, and open fundopl...Figure 28.15 The Stretta system. Use of a balloon to deliver radiofrequency ...Figure 28.16 Injection of liquid polymer into the esophageal mucosa. The Ent...

17 Chapter 30Figure 30.1 Active bleeding F 1b from a duodenal ulcer.Figure 30.2 Adherent clot (F 2b) at the base of a gastric ulcer.Figure 30.3 A flat pigmented spot (F 2c) at the base of a duodenal ulcer.Figure 30.4 Clear base of a duodenal ulcer (F 3).Figure 30.5 Single‐use preloaded rotatable two‐pronged clips: a single clip....Figure 30.6 Over‐the‐scope clip.Figure 30.7 Delivery system.

18 Chapter 31Figure 31.1 Large esophageal varices before and after band ligation.Figure 31.2 (a) EUS varices preinjection. (b) EUS varices with needle.Figure 31.3 Varices being banded.Figure 31.4 Varices with EUS probe.Figure 31.5 Cutting the catheter after glue injection prior to removal to pr...