Introduction Zenker's diverticulum (ZD) is a posterior pharyngoesophageal mucosal outpouching that forms through Killian's triangle. Poor upper esophageal sphincter (UES) compliance is the acknowledged pathophysiologic mechanism of action, leading to creation of a high-pressure zone, ultimately resulting in diverticulum formation.…
Introduction Esophageal motility disorders are ubiquitous in gastroenterology practice today, and developments in technology have led to a revolution in both their diagnosis and treatment. This chapter focuses on clinically significant esophageal motility disorders relevant to gastrointestinal endoscopy practice, primarily…
Introduction Chronic gastrointestinal (GI) hemorrhage may be overt or occult. Overt bleeding is defined as chronic if it is persistent but not severe enough to cause circulatory compromise. It may be seen in the form of melena or red rectal…
Introduction Traditionally, obscure gastrointestinal bleeding (OGIB) is reported to account for approximately 5% of all gastrointestinal (GI) bleeding and is defined as bleeding from an unknown source that persists or recurs after negative bidirectional endoscopic diagnostic evaluations. A negative bidirectional…
Introduction Acute severe lower gastrointestinal (GI) bleeding is a common problem and frequent reason for hospitalization. Colonoscopy is often performed for diagnosis and potential therapeutic intervention. This chapter focuses on moderate to severe acute lower GI bleeding, defined as hematochezia,…
Introduction Portal hypertension is defined by a pathologic increase in portal pressure in which the pressure gradient between the portal vein and inferior vena cava (the portal pressure gradient, PPG) is increased above the upper normal limit of 5 mm Hg.…
Introduction The annual incidence of upper gastrointestinal bleeding (UGIB) is 48 to 160 events per 100,000 adults in the United States, where it is the cause of approximately 300,000 hospital admissions per year. In Europe, the annual incidence of UGIB…
Introduction Safe performance of gastrointestinal endoscopic procedures requires extensive and high-quality training. Endoscopy skills have traditionally been taught within the clinical setting, in the form of a mentor-apprenticeship model in which novice endoscopists learn skills under the supervision of experienced…
Introduction Patients who have undergone surgical procedures that altered the upper gastrointestinal (GI) anatomy are often referred for endoscopic evaluation. It is essential for gastroenterologists to understand the postoperative anatomical alterations to select the appropriate endoscope and accessories and obtain…
Rationale Upper endoscopy is an important diagnostic tool in the care of patients with gastrointestinal (GI) diseases. Unfortunately, there is a certain amount of discomfort and patient intolerance associated with unsedated procedures. For this reason, physicians are hesitant to use…