Gastro liver centre bahria town international hospital lahore

Gastro liver centre bahria town international hospital lahore All Gastroenterologist and Hepotologist procedures Bahria International Hosiptal Lahore

Visualized portion of Esophagus,Stomach & Duodenum appeared normal,CBD stent in situ, partial luminal narrowing distal t...
13/10/2025

Visualized portion of Esophagus,Stomach & Duodenum appeared normal,
CBD stent in situ, partial luminal narrowing distal to Ampulla.CBD stent Removed with snare, selective CBD. Cannulation done,half strength contrast injected, Gross dilated CBD with distal stricture. Partially covered metallic stent 10mm x 80mm placed in CBD bridging the striciure site, Free fiow of biie seen.

Visualized portion of Esophagus, Stomach & Duodenum appeared normal,CBD stent in situ,Removed with snare,Selective CBD c...
13/10/2025

Visualized portion of Esophagus, Stomach & Duodenum appeared normal,
CBD stent in situ,Removed with snare,Selective CBD cannulation done ,Half strength contrast injected, Gross dilated CBD(>2cm) with a distal stricture. Partially covered metallic stent 10mm x 100mm placed in CBD bridging the stricture site. Free flow of bile seen.

Need to share you opinion in this case of 29 year old male patient with recurrent biliary obstruction.Both CECT and MRI ...
03/10/2025

Need to share you opinion in this case of 29 year old male patient with recurrent biliary obstruction.
Both CECT and MRI were misleading 😞.
ERCP showed : Giant Paris 0-Isp duodenal polyp making marked distortion of the duodenal anatomy, hiding the papillary punctum & compressing the CBD. The surface mucosa was JNET IIa.
EUS showed: Large polypoid mass about 50x50 mm, respecting the muscle layer, with two big feeding vessels running at its core. The CBD about 13 mm.

What is the best treatment option for this case?????

17/12/2024

Second part of duodenum accessed. Ampulla identified. Previously placed blocked stents seen in situ in CBD.Previously placed stents removed. After cannulation of ampulla, Selective cannulation of CBD done. Guide wire passed in CBD. Guide wire passed in anterior and posterior sectoral ducts. Contrast injected. Previous site of anastomotic stricture at the anterior and posterior sectoral ducts seen sufficiently dilated. Stricture site dilated with Biliary CRE balloon 8mm. Stricture seen sufficiently dilated on occlusion cholangiogram. Balloon trawling of CBD done with biliary stone extraction balloon. Copious amounts of pus retrived.Free flow of bile seen. Patient tolerated the procedure well. No immediate complications seen

14/12/2024

ESOPHAGUS
Normal upper and middle third. Lower third showing a short column of
Grade I varix.
STOMACH
Normal body and fundus.
No fundal varix seen.
Multiple telengiectasias seen in the antrum.
Argon Plasma Coagulation (APC) done and hemostasis secured.
Normal pylorus.
DUODENUM
Normal duodenal bulb

14/12/2024

ESOPHAGUS
Normal upper and middle third. Distal third normal.
STOMACH
Normal fundus.
Normal body.
Mild Antral gastritis seen in antrum.
Normal pylorus.
DUODENUM
Normal duodenal bulb.
One stent seen in situ in second part of duodenum. Stent removed with the help of biopsy forceps.

14/12/2024

DUODENUM Normal bulb .
Normal Distal Duodenum.
GASTRIC BALLOON PLACEMENT
Gastric Balloon seen in situ in the gastric body under direct and endoscopic vision. Balloon deflated completely. 700 ml of fluid removed. Balloon removed from the stomach. Patient tolerated the procedure well

14/12/2024

ESOPHAGUS
Normal Upper and middle third. Lower third showing 2 columns of Grade
II varices.2 bands applied
STOMACH
Mild Portal hypertensive Gastropathy seen in body and fundus.
Edematous mucosal fold seen near the fundus.
Mild Portal hypertensive gastropathy seen in the antrum.
Normal pylorus

14/12/2024

Appropriate site for PEG insertion selected under direct and endoscopic control. 24 F pull type PEG tube placed under direct and endoscopic control . ASD Done

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