Hi guys, Welcome to the Advanced Video Search Engine, and you are watching ERCP IN THE MULTIVERSE. That video is uploaded by monzahmed at 2024-07-04T10:00:23-07:00. We are promoting this video only for entertainment and educational purpose only. So, I hope you like & enjoy it. [sWtThsXTkk8]
| Name | ERCP IN THE MULTIVERSE |
| Video Uploader | Video From monzahmed |
| Upload Date | This Video Uploaded At 04-07-2024 17:00:23 |
| Video Discription | This is an unusual paediatric case the likes of which we do not see very often as adult gastroenterologists. Please watch the video which has an audio commentary. The patient is an 11 year old girl who presented as a neonate with vomiting, abdominal distention and failure to thrive. She also had bladder dysfunction and had difficulty in voiding urine. She was commenced on TPN at age 6 weeks and at age 4 months was diagnosed with chronic intestinal pseudo-obstruction (CIPO). At age 7 months she had a venting gastrostomy and ileostomy. At 10 months she had a total colectomy (rectum left in situ) because of severe diversion colitis. At 17 months the ileostomy was closed and an ileo-rectal anastomosis was fashioned. Unfortunately she again developed vomiting and the ileostomy was re-formed at age 26 months. She developed gallstones secondary to the TPN and had a cholecystectomy at the age of 3 years. At this stage a diagnosis of VISCERAL MYOPATHY with chronic intestinal pseudo-obstruction and bladder dysfunction was made. The bladder dysfunction was treated with a suprapubic catheter. She had numerous complications including recurrent central line infections, recurrent urinary tract infections/ pyelonephritis, prolonged absence from school and a low mood. At age 9.5 years a Mitrofannof procedure was performed and a year later she had a Modified Multivisceral Transplant (MMVT) with stomach, doudenum, pancreas and small intestines (but not colon) being transplanted. The patient retained her own liver and spleen. A duct-to-duct biliary anastomosis was formed connecting the donor and recipient bile ducts. Tacrolimus and Prednisolone were used to prevent graft rejection. The patient did very well post transplantation and the vomiting/ distention subsided. She was able to eat normally and TPN was discontinued very soon after the operation. Four months after the transplant she developed a rash and abnormal liver chemistry. A skin biopsy did not show graft versus host disease (GVHD). An ultrasound scan and MRCP, 8 months after transplantation, showed dilated intrahepatic ducts, a dilated CBD and a fibrotic stricture at the biliary anastomosis. Hence the patient underwent two ERCPs to dilate the stricture with a balloon followed by stent insertion (see video). Subsequently the liver biochemistry improved. — continued in first comment.... sWtThsXTkk8 |
| Category | Education |
| Tags | endoscopy | therapeutic endoscopy | gut | GI tract | medicine | gastroenterology | monz | monz ahmed | monzahmed | monzur ahmed | ERCP | visceral myopathy | CIPO | chronic intestinal pseudo-obstruction | mutation | TPN | multivisceral transplant | modified multivisceral transplant | immunosupression | biliary stricture | dilatation | stent | metal stent |
