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

2. Upper esophagus

3. Larynx Upper esophagus Lower esophagus

4. 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

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

8. EUS Head Calcifications Wirsung 11mm

9. ?

10. EUS guided pancreaticogastrostomy AB C D

13. EUS – guided pancreaticogastrostomy Francois et al. Gastrointestinal Endoscopy 2002 4 patients 3 of 4 had satisfactory pain relief 1 year follow-up

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

15. CT Hepatic artery phase PVP Late phase

16. MRI T1Contr hepatic artery phase

17. Differential diagnosis Atypical hemangioma Hemangiosarcoma Necrotic tumor Peliosis hepatis Other

18. Liver biopsy

19. Peliosis hepatis - Black and Blue Liver

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

21. 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

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

23. Cocoon syndrome

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