ABSTRACT
Gastric ectopic pancreas (EP) is an uncommon congenital anomaly in which pancreatic tissue with no anatomic connection to the main pancreas is found in the stomach. Gastric EP is often discovered incidentally when a nonspecific submucosal tumor is found in endoscopic studies or other imaging examinations. Tissue characterization by biopsy or fine-needle aspiration is required as endoscopic findings alone cannot exclude malignancy. The authors present 2 cases of gastric EP incidentally detected on endoscopy, which underwent further characterization by magnetic resonance imaging (MRI). In both cases, MRI showed submucosal gastric lesions, isointense to the orthotopic pancreas in all sequences, including hyperintensity on T1-weighted images. Furthermore, the lesions showed bright arterial phase enhancement, paralleling the native pancreas. MRI may provide the best non-invasive imaging method for evaluating gastric submucosal lesions. This report intends to show that EP shows a characteristic MR appearance that allows differentiation from other submucosal lesions.
ABSTRACT
Background and study aim Outbreak of COVID-19 began in Wuhan in December 2019 and has rapidly spread from China to the rest of the world. Although it is primarily transmitted by contact and droplets, aerosol-generating procedures also seem to carry the possibility of airborne viral transmission. As such, upper gastrointestinal endoscopy can be considered a risky procedure, with several position statements recommending the adoption of safe practices in endoscopic procedures. This article aims to describe an additional tool to protect healthcare personnel during endoscopy. Methods A covering box made of acrylic plastic, named Endoprotector, was designed to cover the patient's head, while taking into consideration movements performed by patients and healthcare staff during an endoscopic procedure. Results A cough simulation using fluorescent dye confirmed the potential benefit of the box during endoscopy, thus protecting healthcare staff from air droplets. The feasibility and practicality of the box was also tested with patients during endoscopy. Conclusion The reusable Endoprotector is easily and affordably manufactured and may reduce air droplets and airborne transmission of SARS-CoV-2 and other microorganisms during endoscopy.
ABSTRACT
Here we present the case of a 35-year-old female patient with long standing dyspepsia and imaging studies showing the presence of multiple cysts in the head and tail of the pancreas. The patient underwent endosonography that confirmed the presence of multiple simple cysts throughout the entirety of the pancreas without dilation of the pancreatic duct. The majority of the cysts were less than one centimeter in size, and the largest cyst showed a honeycomb appearance. Cytology of aspirates from the two largest cysts was compatible with benign pancreatic cysts. Endosonography also revealed cysts within the left kidney and spleen. Genetic testing confirmed Von Hippel-Lindau disease. We highlight this case because it is unusual for Von Hippel-Lindau disease, a rare clinical entity, to present solely with cysts in the absence of more common manifestations, such as hemangioblastomas in the central nervous system and malignancy.