Here are some selected slides and notes from this year’s NASPGHAN’s postrgraduate course.  My notes from these lectures may contain errors in omission or transcription.

Link to the full NASPGHAN PG Syllabus 2019

8:00 – 9:00 Module 1 – Endoscopy

11  David Brumbaugh, MD, Children’s Hospital Colorado  Management of foreign bodies

Related blog posts:

• Foreign Bodies in Children -Expert Guidance
• New Button Battery Guidelines -with honey and vinegar
• Button battery -Update For Families
• Foreign Bodies in Children: Expert Recommendations
• Magnetic Foreign Bodies -Still a Problem | gutsandgrowth
• More on magnet ingestions | gutsandgrowth
• Cheap Technology for Button Battery Ingestions | gutsandgrowth
• Watch for change in the stools” | gutsandgrowth

22 Petar Mamula, MD, Children’s Hospital of Philadelphia Advanced endoscopic techniques for gastrointestinal bleeding

This talk had some terrific videos (not available in syllabus) and useful practical points.  For example, with cautery, the speaker recommended not just quickly taping the lesion, count for several seconds when applying.  For hemospray, the speaker considers this technically much easier but is using this mainly as a backup option.

Here are two screenshots (not from lecture) which provide information from manufacturer on Hemospray use (link to PDF on Hemospray Manufacturer’s PDF on Hemospray)

Related blog posts:

• All bleeding stops (part 2)
• All bleeding stops
• Hemospray for GI Bleeding
• Watch the Bleeding Ulcer Stop! | gutsandgrowth
• Transfusion strategy in acute GI bleeding | gutsandgrowth

36 Srinadh Komanduri, MD, Northwestern Medicine  Cancer screening top to bottom

Some of the key points:

• IBD and colorectal cancer (CRC) screening 8-10 years after disease onset
• ~10% of CRC in general population occurs between 20-49 years
• Chromoendoscopy results in higher detection rates of dysplasia

Related blog posts:

• Colon cancer at younger ages
• Five Ways to Lower the Risk of Colon Cancer
• What I Like About ESPGHAN Familial Adenomatous Polyposis Guidelines These recommendations, however, suggest starting screening at 12-14 years.
• ESPGHAN Juvenile Polyposis Syndrome Recommendations  These recommendations are different in that they do not recommend EGD in the pediatric age group: “Surveillance of the upper GI tract in affected or at-risk JPS patients is not required in childhood or teenage years, unless there is unexplained anaemia or upper GI symptoms.”
• ESPGHAN Peutz-Jeghers syndrome Guidelines
• Are You Familiar with CMMR-D? The term CMMR-D refers to constitutional mismatch repair deficiency.  This occurs when an individual inherits two MMR gene defects (rather than one gene defect in Lynch syndrome); with CMMR-D screening recommendations include yearly endoscopic evaluation beginning at age 3 years or at diagnosis.
• Updated Guidelines on Genetic Testing/management for Hereditary GI Cancer Syndromes
• Update for Peutz-Jegher Syndrome

Disclaimer: NASPGHAN/gutsandgrowth assumes no responsibility for any use or operation of any method, product, instruction, concept or idea contained in the material herein or for any injury or damage to persons or property (whether products liability, negligence or otherwise) resulting from such use or operation. The discussion, views, and recommendations as to medical procedures, choice of drugs and drug dosages herein are the sole responsibility of the authors. Because of rapid advances in the medical sciences, the Society cautions that independent verification should be made of diagnosis and drug dosages. The reader is solely responsible for the conduct of any suggested test or procedure. Some of the slides reproduced in this syllabus contain animation in the power point version. This cannot be seen in the printed version.