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Andy Tau, MD

@DrBloodandGuts • 9,157 subscribers

Gastroenterology Hospitalist @AustinGastro. Trained @BCMhouston, @Harvard

Shorts

“DU Your Best: Duodenal Ulcer Hemostasis Tutorial” I will go step by step through my thoughts [#] and struggle. This pt was transferred for IR embolization after re-bleeding after initial EGD (epi+clip) [#1 - Guidelines recommend repeat EGD after 1st rebleed, not IR]

“DU Your Best: Duodenal Ulcer Hemostasis Tutorial” I will go step by step through my thoughts [#] and struggle. This pt was transferred for IR embolization after re-bleeding after initial EGD (epi+clip) [#1 - Guidelines recommend repeat EGD after 1st rebleed, not IR]

38,609 views

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Bipolar cautery is a bit of a lost art of hemostasis. Ensure the probe >= vessel. Also, use the dials to optimize the vector of pressure laterally. This may change in real time during the process. I let it cool and irrigate before pulling off. I use epi before or after.

Bipolar cautery is a bit of a lost art of hemostasis. Ensure the probe >= vessel. Also, use the dials to optimize the vector of pressure laterally. This may change in real time during the process. I let it cool and irrigate before pulling off. I use epi before or after.

15,780 views • 1 month ago

Hemospray has been showed to be a game changer when it comes to malignant GI bleeding. There is great value in a temporizing measure for massive tumors like this one in esophagus.

Hemospray has been showed to be a game changer when it comes to malignant GI bleeding. There is great value in a temporizing measure for massive tumors like this one in esophagus.

78,391 views • 1 year ago

Hot biopsy forceps 3 ways— closed on vessel, open on vessel, clot removal and simultaneous cautery.

Hot biopsy forceps 3 ways— closed on vessel, open on vessel, clot removal and simultaneous cautery.

14,822 views • 2 months ago

$Worst cholangitis ever. So much PUS and is almost NSFW. There are some cholangitis that are real emergencies (HD unstable, refractory septic shock, multiorgan failure). This was one of them. #GITwitter$

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Worst cholangitis ever. So much PUS and is almost NSFW. There are some cholangitis that are real emergencies (HD unstable, refractory septic shock, multiorgan failure). This was one of them. #GITwitter

118,937 views • 3 years ago

Behold the “Megacap” ie Ovesco Endoscopy RemOVE FBR Kit. Remove food bolus en bloc by suctioning rather than pushing blindly inward. The large soft cap allows large volumetric capture and folds to allow for passage down the oropharynx easily. The long cap prevents the bolus from jamming the suction channel (as it would short caps). When you see “food out, during suctioning, start to wiggle out and reveal your prize!

Behold the “Megacap” ie Ovesco Endoscopy RemOVE FBR Kit. Remove food bolus en bloc by suctioning rather than pushing blindly inward. The large soft cap allows large volumetric capture and folds to allow for passage down the oropharynx easily. The long cap prevents the bolus from jamming the suction channel (as it would short caps). When you see “food out, during suctioning, start to wiggle out and reveal your prize!

10,700 views • 2 months ago

Big clots are still a big problem in modern endoscopy. Here is a method to turn a flexible/rigidizing overtube into a large suction attachment to evacuate clots rapidly from the stomach. #GITwitter Douglas G. Adler MD, FASGE, FACG, AGAF Rashmi Advani, MD, ABOM Tarun Rustagi Neil Sharma, M.D. FASGE, FACG, AGAF SAGES is in Vegas in 2027!

Big clots are still a big problem in modern endoscopy. Here is a method to turn a flexible/rigidizing overtube into a large suction attachment to evacuate clots rapidly from the stomach. #GITwitter Douglas G. Adler MD, FASGE, FACG, AGAF Rashmi Advani, MD, ABOM Tarun Rustagi Neil Sharma, M.D. FASGE, FACG, AGAF SAGES is in Vegas in 2027!

64,321 views • 2 years ago

When banding internal hemorrhoids in retroflexion, wherever you think you should suction, move another 1cm away from anus to avoid banding the transition zone which is partly sensate. The cap always volumetrically captures a lot more tissue distally than expected. #GITwitter

When banding internal hemorrhoids in retroflexion, wherever you think you should suction, move another 1cm away from anus to avoid banding the transition zone which is partly sensate. The cap always volumetrically captures a lot more tissue distally than expected. #GITwitter

41,060 views • 1 year ago

The ultimate “clot buster” has arrived. Finally in stock at my hospitals ! Excited to start clearing clots in seconds :) #GITwitter

The ultimate “clot buster” has arrived. Finally in stock at my hospitals ! Excited to start clearing clots in seconds :) #GITwitter

34,181 views • 1 year ago

Snaring an adherent clot should use the same strategy as snaring a polyp. Make sure you get max capture on the first grab. #GITwitter

Snaring an adherent clot should use the same strategy as snaring a polyp. Make sure you get max capture on the first grab. #GITwitter

35,371 views • 2 years ago

I am proud to be able to show this now! The Pathfinder CR coverts the existing flexible overtube into an unmatched suction device. The clots pass around the scope and within the tube. This is under direct visualization. I presented this innovation at DDW Shark Tank. #GITwitter

I am proud to be able to show this now! The Pathfinder CR coverts the existing flexible overtube into an unmatched suction device. The clots pass around the scope and within the tube. This is under direct visualization. I presented this innovation at DDW Shark Tank. #GITwitter

32,181 views • 2 years ago

A patient develops pain when bolus feeding their PEG tube (20d old). You suspect buried bumper syndrome, but how do you proceed if the bumper out of the stomach? #GITwitter

A patient develops pain when bolus feeding their PEG tube (20d old). You suspect buried bumper syndrome, but how do you proceed if the bumper out of the stomach? #GITwitter

35,720 views • 2 years ago

‘‘Twas the night before Christmas and all through the house, not a creature was stirring except … a food bolus through the esophagus and into the chest.” This is why food impaction are emergencies. #GITwitter

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‘‘Twas the night before Christmas and all through the house, not a creature was stirring except … a food bolus through the esophagus and into the chest.” This is why food impaction are emergencies. #GITwitter

28,398 views • 3 years ago

A patient with hemorrhagic shock has a duodenal ulcer with a visible vessel larger than the 10Fr bipolar probe. What do you do next ? #GITwitter

A patient with hemorrhagic shock has a duodenal ulcer with a visible vessel larger than the 10Fr bipolar probe. What do you do next ? #GITwitter

23,054 views • 2 years ago

Just got my hands on this NEW fully rotatable sphincterotome! The rotation is silky smooth & adds the final degree of freedom missing in tip control so badly needed in: intra-dochal (hilar, cystic), altered anatomy ERCP and papilla in duodenal diverticulum! #GITwitter

Just got my hands on this NEW fully rotatable sphincterotome! The rotation is silky smooth & adds the final degree of freedom missing in tip control so badly needed in: intra-dochal (hilar, cystic), altered anatomy ERCP and papilla in duodenal diverticulum! #GITwitter

20,262 views • 2 years ago

At TSGE, my favorite toy of all: Neptune Pathfinder CR (Clot removal), which is an adapter that coverts the existing Pathfinder overtube into an unmatched suction hose. Disclosure: I helped developed this (very proud!) The CR adapter is about the cost of a clip! #GITwitter

At TSGE, my favorite toy of all: Neptune Pathfinder CR (Clot removal), which is an adapter that coverts the existing Pathfinder overtube into an unmatched suction hose. Disclosure: I helped developed this (very proud!) The CR adapter is about the cost of a clip! #GITwitter

14,878 views • 1 year ago

Jump Scare! Duodenal EMR’s are notorious for post-resection bleeding (despite suturing!). Here I demonstrate bipolar coaptive cautery of a vessel. Combo therapy with thermal and mechanical is most durable IMO. #GITwitter

Jump Scare! Duodenal EMR’s are notorious for post-resection bleeding (despite suturing!). Here I demonstrate bipolar coaptive cautery of a vessel. Combo therapy with thermal and mechanical is most durable IMO. #GITwitter

13,634 views • 1 year ago

The combination of Erosive Esophagitis and varices is a bad one. Here is is a case of Grade C Esophagitis and EV resulting in an obvious high risk stigmata. #GITwitter

The combination of Erosive Esophagitis and varices is a bad one. Here is is a case of Grade C Esophagitis and EV resulting in an obvious high risk stigmata. #GITwitter

16,070 views • 2 years ago

To all general GI fellows: This is a through-the-scope fully covered self expanding esophageal metal stent (TTS FCSEMS). Learn to deploy this. It needs no fluoroscopy, but does need a therapeutic gastroscope. It’s as easy as leaving a guidewire behind. #GITwitter

To all general GI fellows: This is a through-the-scope fully covered self expanding esophageal metal stent (TTS FCSEMS). Learn to deploy this. It needs no fluoroscopy, but does need a therapeutic gastroscope. It’s as easy as leaving a guidewire behind. #GITwitter

13,990 views • 2 years ago

This is my favorite way to ablate EMR edges. It’s not APC and not soft coagulation. It’s a little know setting called spray coagulation! It cost nothing! This is a snare and the tip can even be just inside the catheter to maximize safety via non contact hemostasis. #GITwitter

This is my favorite way to ablate EMR edges. It’s not APC and not soft coagulation. It’s a little know setting called spray coagulation! It cost nothing! This is a snare and the tip can even be just inside the catheter to maximize safety via non contact hemostasis. #GITwitter

10,152 views • 1 year ago

A trauma patient develops melena, shock, AST/ALT 1000’s and obstructive LFTs. The pt has chest tubes and is intubated. You encounter bleeding in D2. No prior ERCP (ever). What is this and possible causes? What do you do? How do you stop bleeding? #GITwitter

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A trauma patient develops melena, shock, AST/ALT 1000’s and obstructive LFTs. The pt has chest tubes and is intubated. You encounter bleeding in D2. No prior ERCP (ever). What is this and possible causes? What do you do? How do you stop bleeding? #GITwitter

12,786 views • 2 years ago