Case 1 82 y.o. female82 y.o. female Retrosternal burningRetrosternal burning Long standing dysphagiaLong standing dysphagia

Upper esophagus

Larynx Upper esophagus Lower esophagus

Diverticulum Diverticulum Duplication of esophagus Duplication of esophagus Congenital double lumen esophagus Congenital double lumen esophagus Fistula Fistula None of the above None of the above

Case 2 49 y.o. woman Chronic idiopathic pancreatitis Severe pain – on narcotics ERCP X 2: failed cannulation of Wirsung due to severe stricture

EUS Head Calcifications Wirsung 11mm

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EUS guided pancreaticogastrostomy AB C D

EUS – guided pancreaticogastrostomy Francois et al. Gastrointestinal Endoscopy patients 3 of 4 had satisfactory pain relief 1 year follow-up

Case 3 51 y.o. woman with mild RUQ pain No relevant medical history No medications Normal physical examination

CT Hepatic artery phase PVP Late phase

MRI T1Contr hepatic artery phase

Differential diagnosis Atypical hemangioma Hemangiosarcoma Necrotic tumor Peliosis hepatis Other

Liver biopsy

Peliosis hepatis - Black and Blue Liver

Etiology Wasting illness Carcinomatosis Drugs (anabolics, steroids, oral contraceptives, azathioprine) Immunosuppressed patients AIDS – bacillary angiomatosis peliosis Idiopathic

Case 4 51 y.o. man Diabetes mellitus type II, target organ damage, no prior abdominal operations Abdominal pain, vomiting, weight loss Palpable mass at the right upper quadrant

- Partial pseudoobstruction - Retroperitoneal fibrosis - Sclerosing peritonitis - Paraduodenal hernia - Amyloidosis Differential diagnosis - Partial pseudoobstruction - Retroperitoneal fibrosis - Sclerosing peritonitis - Paraduodenal hernia - Amyloidosis

Cocoon syndrome

First described in 1978 Idiopathic, sclerosing, encapsulating peritonitis - congenital - idiopathic - secondary (peritoneal dialysis, peritoneovenous shunts, beta-blockers, peritoneal TB, GI malignancy)