Carlos Rodríguez Pérez

DAT clip revisión y manejo del nuevo clip de cierre de Micro-tech youtu.be/VFV2AvSvMj4?si… a través de @YouTube

How to diagnose coeliac disease: highlights from the updated 2025 guidelines in @UEGJournal 🔗: onlinelibrary.wiley.com/doi/full/10.10…

This 80 year old had a colonoscopy for rectal bleeding 6 months ago. A low rectal tumour was diagnosed (adenocarcinoma; T2N1M0, pictured left). He was started on high dose radiotherapy and oral capecitabine chemotherapy, with view to surgery. However, endoscopies 3 months and 6 months later (pictured right), in addition to MRI follow-up, showed complete remission of his cancer with only a tidy scar left behind. Complete response to chemoradiotherapy for rectal cancer is unusual but can happen in up to 20% of patients.

Deploying an OTSC on a ulcer base is tricky business. It’s still an art to me because the base cannot be so fibrotic as to not be able to enter the cap upon suction. I sometimes tap suction to tests its rigidity. One key it to desufflate the walls or even go underwater (think underwater EMR). #GITwitter

OTSC spikes matter: 't' (therapeutic/sharp) vs 'a' (atraumatic/rounded). Size notation example: 12/6t = 12mm diameter, 6mm length, therapeutic spikes.

No todo lo que parece “gases” o “hinchazón”🪀 es dispepsia o intestino irritable. En estas fechas de fiestas , muchas personas presentan hinchazón, distensión abdominal y malestar postprandial. Podría ser un problema crónico mal identificado durante años. Empieza🧵

Went for EFTR. Path: NET G2, Ki67 4%, 13 mm, R0.

⚠️ Are we over-trusting FIT in iron deficiency anaemia? The new BSG & ACPGBI guidance makes it clear: • A negative FIT does not rule out GI cancer in IDA • Upper GI malignancy risk remains significant • Bidirectional endoscopy is still key • FIT must not delay investigation in high-risk patients 🔓 Full guidance in Frontline Gastroenterology: fg.bmj.com/content/early/… #IDA #FIT #CancerPathways #GIguidelines #FGJournal @bodgoddard @BritSocGastro @ACPGBI @RCGP @PhilSmithIsBack @OTavabie @dr_aditi_kumar @TrevorTabone @eathar_s @IrenePerezMD @KGananandan @zare_benjamin @medicalreg @dtleiberman @BASLedu @BSGtrainees @WorldGastroOrg @ulstergastro @SEEDendoscopia @AmCollegeGastro @Aegastro @SAGES_updates @UHSEndoscopy @WAGE_media

🔬 New Insights on Preventing Esophageal Strictures After ESD Endoscopic submucosal dissection (ESD) is a powerful tool for removing gastrointestinal neoplasms — but postoperative esophageal stenosis (PES) remains one of its most challenging complications. 💡 Our latest SRMA (16 studies, 1,056 patients) shows that steroid administration significantly reduces PES rates and decreases the need for endoscopic balloon dilatation (EBD) — all without increasing adverse events. 📊 Key takeaways: 📉 PES risk reduced with steroids (OR = 0.36). 🔄 Fewer EBD sessions were required (MD = −1.20). 💉 Systemic steroids outperformed local steroids 💊 Prednisolone more effective than triamcinolone ⏱️ Timing of administration did not affect outcomes ✅ Bottom line: Steroid therapy is a safe and effective strategy to prevent PES after ESD, with systemic prednisolone showing the greatest clinical benefit. 🔗journals.lww.com/jcge/abstract/…

This is really exciting! Acute pancreatitis! Over 1200 patients included from all over the 🌍 in the Waterland 🌊 trial @DeMadaria . Ringers lactate vs Saline. ⚔️ Conclusion: no impact on major clinical endpoint but 🔽 inflammatory markers and 🔼 safety using Ringers @my_ueg

The MIRacle Sign thepracticingendoscopist.com/p/the-miracle-…

📌 Clasificación de Siewert – Adenocarcinomas de la unión esofagogástrica • Tipo I → esófago distal, centro 1–5 cm por arriba de la unión esofagogástrica (UEG). • Tipo II → verdadero cardias, centro entre 1 cm por arriba y 2 cm por debajo de la UEG. • Tipo III → subcardial, centro 2–5 cm por debajo de la UEG.

Underwater EMR is especially useful in characterizing periappendiceal polyps. This lesion initially appeared as a broad-based sessile polyp filling the appendiceal lumen. After filling the lumen with water, its proper morphology was revealed as pedunculated with a clear stalk. What seemed complex became straightforward: the stalk was easily visualized, snared, and safely removed. #UnderwaterEMR

✅ Breve revisión sobre la ligadura endoscópica con banda para ectasias vasculares antrales gástricas (GAVE)

Vuelta al cole en Endoaula!🚀Arrancamos la 3°ed del Programa de Especialización en DSE y 3°espacio con alumnos magníficos super concentrados que ya han sacado sus primeras piezas🏅y un puesto de estudio individual para correcciones personalizadas y un feedback aún más completo📋

2 weeks ago, I gave GI Grand Rounds going over colon polyp evaluation & management Received a text this week from a 2nd year fellow that warmed my heart 😊 THIS is the beauty of academic medicine! With pedunculated polyps, cut LOW on stalk to increase chance of R0 resection! Up to 1/3rd of malignant pedunculated polyps are Haggitt Level 3 (cancer in stalk), so you have to get low to increase chance of cure.

‼️¿Enfermedad celíaca (EC) que NO mejora con dieta sin gluten? 👉 Podría no ser EC refractaria... sino insuficiencia pancreática exocrina (IPE)‼️ Un nuevo metaanálisis lo deja claro: 1 de cada 8 pacientes con EC tiene IPE😮 📊12 estudios, N: 675 con EC confirmada por biopsia.

Endoscopic resection of the largest gastric polyp I have ever seen - you won’t believe how it was retrieved 😳 x.com/Stentingwoman/…

🧼 ¿Preparación intestinal de calidad? Nueva guía 2025 de la USMSTF para colonoscopia: 25 recomendaciones basadas en evidencia para mejorar limpieza, detección y eficiencia endoscópica 📄 Publicado en Gastroenterology: 🔗 doi.org/10.1053/j.gast… 👇Abrimos hilo con lo esencial👇

🧵 Nueva Guía 2025 sobre PANCREATITIS AGUDA ‼️Sin grandes novedades, pero sí un repaso riguroso y práctico de TODO lo que ya deberías tener presente‼️ 📘 Elaborada por IAP, APA, EPC, IPC y JPS. 💡 Ideal para gastroenterólogos que quieren actualizarse. ¡Vamos allá! 👇