Tom Lynn

10 statements · 5 topics · summaries given as host listed separately

Pancreatitis · guest expert

Featured statements

Transpapillary pancreatic stent placement has a greater likelihood of success if capable of bridging the defect, but certain leaks can still resolve despite not being able to successfully bridge the defect within the pancreatic duct.
clinical · Acute Pancreatitis
In adult literature, there is growing evidence for endoscopic necrosectomy via EUS (transmural approach through stomach into necrotic cavity) showing good outcomes, but pediatric experience is extremely limited.
clinical · Acute Pancreatitis
Adult evidence supports endoscopic necrosectomy via EUS-guided transmural approach with good outcomes; pediatric experience is extremely limited and Cincinnati has not performed this procedure.
clinical · Acute Recurrent Pancreatitis
Management intervention choice for pseudocysts can be very much based on local expertise that the facility has as well as the presence or severity of patients' comorbidities.
opinion · Chronic Pancreatitis

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Tom's statements about Acute Pancreatitis 4 statements

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Acute Pancreatitis

Statement In adult literature, there is growing evidence for endoscopic necrosectomy via EUS (transmural approach through stomach into necrotic cavity) showing good outcomes, but pediatric experience is extremely limited. Open

Endoscopic & Surgical Interventions: Pancreatic Disease

Statement Transpapillary pancreatic stent placement has a greater likelihood of success if capable of bridging the defect, but certain leaks can still resolve despite not being able to successfully bridge the defect within the pancreatic duct. Open
Statement Management intervention choice for pseudocysts can be very much based on local expertise that the facility has as well as the presence or severity of patients' comorbidities. Open

Acute Pancreatitis

Statement Adult evidence supports endoscopic necrosectomy via EUS-guided transmural approach with good outcomes; pediatric experience is extremely limited and Cincinnati has not performed this procedure. Open
Tom's statements about Acute Recurrent Pancreatitis 1 statement

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Acute Pancreatitis

Statement Adult evidence supports endoscopic necrosectomy via EUS-guided transmural approach with good outcomes; pediatric experience is extremely limited and Cincinnati has not performed this procedure. Open
Tom's statements about Chronic Pancreatitis 2 statements

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Endoscopic & Surgical Interventions: Pancreatic Disease

Statement Transpapillary pancreatic stent placement has a greater likelihood of success if capable of bridging the defect, but certain leaks can still resolve despite not being able to successfully bridge the defect within the pancreatic duct. Open
Statement Management intervention choice for pseudocysts can be very much based on local expertise that the facility has as well as the presence or severity of patients' comorbidities. Open
Tom's statements about Hirschsprung disease 1 statement

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Acute Pancreatitis

Statement In adult literature, there is growing evidence for endoscopic necrosectomy via EUS (transmural approach through stomach into necrotic cavity) showing good outcomes, but pediatric experience is extremely limited. Open
Tom's statements about Pancreatitis 2 statements

Open the Pancreatitis collection →

Acute Pancreatitis

Statement In adult literature, there is growing evidence for endoscopic necrosectomy via EUS (transmural approach through stomach into necrotic cavity) showing good outcomes, but pediatric experience is extremely limited. Open

Acute Pancreatitis

Statement Adult evidence supports endoscopic necrosectomy via EUS-guided transmural approach with good outcomes; pediatric experience is extremely limited and Cincinnati has not performed this procedure. Open

Summaries Tom gave as host · 12 summaries

Recaps of other experts' statements, not Tom's own clinical position.

Summaries Tom gave as host · Acute Pancreatitis 6 summaries

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Endoscopic & Surgical Interventions: Pancreatic Disease

Host summary Tom Lynn summarizing the discussion: Pancreatic duct leaks can manifest internally as peripancreatic fluid collections, pseudocysts, pancreatic ascites, pleural effusion, and pancreaticoenteric, biliary, or bronchial fistulas, or externally as pancreaticocutaneous fistulas. Open
Host summary Tom Lynn summarizing the discussion: Risks of endoscopic intervention (EUS or ERCP) include elevated risk for developing or exacerbating pancreatitis, introducing infection into an initially sterile fluid collection, and developing ductal changes including pancreatic duct stricture from temporary endoprosthesis due to foreign body inflammatory response. Open
Host summary Tom Lynn summarizing the discussion: Acute peripancreatic fluid collections develop early in the course of acute pancreatitis, are rare to become infected, and occur in up to 40% of acute pancreatitis patients regardless of etiology, with the majority resolving spontaneously and less than 5% evolving into pseudocysts. Open
Host summary Tom Lynn summarizing the discussion: Pancreatic pseudocysts are formally defined when they reach a time threshold of 4 weeks or greater, contain high amylase-rich content with low fluid and little to no internal debris, and have a well-defined non-epithelialized wall. Open
Host summary Tom Lynn summarizing the discussion: Endoscopic ultrasound provides high resolution imaging of the pancreatic parenchyma as well as the ductal structures both biliary and pancreatic, has both diagnostic and therapeutic capabilities, and these interventions have been clearly well established and beneficial in adults. Open
Host summary Tom Lynn summarizing the discussion: The information and available literature regarding endoscopic ultrasound use in pediatrics is rather limited due to limited data, limited number of pediatric indications currently understood, insufficient awareness of potential capabilities, and very limited number of pediatric gastroenterologists who have attained appropriate training to perform EUS safely and effectively. Open
Summaries Tom gave as host · Chronic Pancreatitis 6 summaries

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Endoscopic & Surgical Interventions: Pancreatic Disease

Host summary Tom Lynn summarizing the discussion: Pancreatic duct leaks can manifest internally as peripancreatic fluid collections, pseudocysts, pancreatic ascites, pleural effusion, and pancreaticoenteric, biliary, or bronchial fistulas, or externally as pancreaticocutaneous fistulas. Open
Host summary Tom Lynn summarizing the discussion: Risks of endoscopic intervention (EUS or ERCP) include elevated risk for developing or exacerbating pancreatitis, introducing infection into an initially sterile fluid collection, and developing ductal changes including pancreatic duct stricture from temporary endoprosthesis due to foreign body inflammatory response. Open
Host summary Tom Lynn summarizing the discussion: Acute peripancreatic fluid collections develop early in the course of acute pancreatitis, are rare to become infected, and occur in up to 40% of acute pancreatitis patients regardless of etiology, with the majority resolving spontaneously and less than 5% evolving into pseudocysts. Open
Host summary Tom Lynn summarizing the discussion: Pancreatic pseudocysts are formally defined when they reach a time threshold of 4 weeks or greater, contain high amylase-rich content with low fluid and little to no internal debris, and have a well-defined non-epithelialized wall. Open
Host summary Tom Lynn summarizing the discussion: Endoscopic ultrasound provides high resolution imaging of the pancreatic parenchyma as well as the ductal structures both biliary and pancreatic, has both diagnostic and therapeutic capabilities, and these interventions have been clearly well established and beneficial in adults. Open
Host summary Tom Lynn summarizing the discussion: The information and available literature regarding endoscopic ultrasound use in pediatrics is rather limited due to limited data, limited number of pediatric indications currently understood, insufficient awareness of potential capabilities, and very limited number of pediatric gastroenterologists who have attained appropriate training to perform EUS safely and effectively. Open