Interventional Gastroenterology

Question 1

acute methods to control bleeding

Answer 1

epinephrine or hemospray

Question 2

good replacement to ngt

Answer 2

egd with percutaneous endoscopic gastrotomy tube placement

Question 3

what is a hemospray

Answer 3

• nonthermal, nontraumatic, noncontact modality that does not require precise targeting
• no tissue changes
• not absorbed by body and does not require removal (passes through gi tract in 72 hrs)

Question 4

what is self expanding metal stent

Answer 4

• can be placed in gi tract

- can be removable or permanent

Question 5

types of sems

Answer 5

• partially covered stent: more stable placement
• covered stent: prevent tumor growth
• uncovered stent: allows tumor ingrowth

Question 6

time to wait before stent is fully expanded

Answer 6

24 hrs

Question 7

stenting modality for biliary obstruction

Answer 7

ercp with metal stenting

Question 8

scenarios in pancreatic head cancer

Answer 8

• bile duct is obstructed first = ercp with metal stenting
• bile duct obstructed -> ercp with metal stenting -> egd with metal stenting of duodenal obstruction
• duodenum is obstructed first -> egd with metal stenting
• egd with metal stent -> pt jaundiced -> ercp with metal stent
• both duodenum and bile duct obstructed -> egd -> ercp

Question 9

complications in peg

Answer 9

• aspiration
• peritonitis
• hemorrhage
• tube migration (buried bumper syndrome)
• gastrocutaneous fistula
• wound infection and necrotizing fasciitis
• inadvertent removal of peg tube
• leakage and blockage

Question 10

complications in ercp

Answer 10

• post ercp pancreatitis
• infection
• bleeding
• perforation

Question 11

role of eus

Answer 11

• view proximity of organs to bv
• determine if tumor can be resected
• fnab
• drainage

Question 12

t/f colonoscopy can be therapeutic

Answer 12

true

Question 13

tx for radiation proctitis

Answer 13

• argon plasma coagulation

- wait 6-8 wks before next tx