This is a case of a 65-year-old gentleman from Sudan who presented with 6 months history of worsening dysphagia to solid food. Gastroscopy revealed a tight distal esophageal stricture involving the distal 8cm of the esophagus. Savary Gillard dilation was performed. Biopsies of the lesion revealed Squamous cell carcinoma. CT scan revealed a 6x6cm mass in distal esophagus with liver metastases. Therefore it was decided to place a self espandable metallic stent for palliation of dysphagia. A 16cm long, 18mm diameter, covered self expandable metal stent with antireflux valve was successfully deployed. Dysphagia disappeared and patient was able to eat normally.

A 45-year-old gentleman presented with right upper quadrant pain of 2 days duration, associated with yellow discoloration of the sclera and tea colored urine. Physical exam revealed jaundice and right upper quadrant abdominal tenderness. Lab: total bilirubin 4.1mg/dl, ALT 146U/L, alkaline phosphatase 568U/L
Abdominal ultrasound showed gall stones and a dilated bile duct.
ERCP (shown on the right):
Multiple stones were found in bile duct, endoscopic sphincterotomy (cutting of the ampulla) and stone extraction was performed successfully. Picture shows extracted yellow stones in the duodenum.
Next day the patient was free of symptoms and his labs were back to normal in 3 days. He underwent laparascopic cholecystectomy (removal of gall bladder) the day after ERCP.