24/08/2026
A Milestone in Therapeutic EUS at United Medical College Hospital
On Tuesday, 18 August 2026, I touched a remarkable milestone in interventional gastroenterology at United Medical College Hospital with the successful performance of two exceptional therapeutic Endoscopic Ultrasound (EUS) procedures—performed for the first time at our hospital and and, to the best of our knowledge, possibly among the first such cases in the private healthcare sector of Bangladesh.
I feel truly privileged to share this wonderful moment with you all. Both patients had an eventless post-procedural recovery, required only one day of hospital stay, and were successfully discharged.
This achievement would not have been possible without the dedication, teamwork, and support of so many wonderful people.
My heartfelt gratitude to Prof. Dr. A.Q.M. Mohsen, Prof. Dr. Touhidul Karim Majumder, my fellow doctors, the Anaesthesia Team, Nurses, Endoscopy Technicians, and the entire United Medical College Hospital management for their invaluable support and cooperation.
A proud and memorable day for our team—and hopefully the beginning of many more advances in therapeutic EUS and advanced interventional endoscopy in Bangladesh.
Please keep us and our patients in your prayers. 🤲
Dr. Taslima Zaman
Associate Professor , Department of Gastroenterology , United Medical College Hospital, Madani Avenue, 100 feet road, Dhaka.
EUS: From diagnosis to therapy. 🔬💡
🔬 A Challenging Case of EUS-Guided Choledochoduodenostomy
A 52-year-old male presented with obstructive jaundice and markedly elevated serum bilirubin levels secondary to pancreatic head malignancy. The case was particularly challenging due to a history of gastrojejunostomy performed in 2011 for severe duodenal stenosis caused by a duodenal ulcer, resulting in altered upper gastrointestinal anatomy and anticipated difficulty with conventional ERCP access.
📌 CT Abdomen:
A large irregular pancreatic head mass (4.4 × 5.4 cm) with peripancreatic fat stranding and involvement of the posterior duodenal wall. The main pancreatic duct (MPD) was markedly dilated to 11.9 mm.
📌 MRCP:
Approximately 4 cm lobulated pancreatic head mass, with C*D dilatation to 10 mm, abrupt distal C*D narrowing and mild intrahepatic biliary dilatation. MPD was dilated to 10 mm.
📌 Histopathology:
CT-guided core biopsy was compatible with adenocarcinoma. CA 19-9 was elevated at 101 U/mL.
📌 Endoscopy:
Previous gastrojejunostomy with significant post-bulbar ulceration and stenosis, making conventional transpapillary access challenging.
📌 EUS Findings:
An irregular mixed-echogenic lesion was seen in the pancreatic head. The C*D was dilated to 9.36 mm, with only 3.7 mm distance between the duodenal wall and C*D. MPD was markedly dilated, measuring 9 mm at the body. The post-bulbar region was significantly narrowed due to external compression.
➡️ EUS demonstrated a dilated C*D in close proximity to the duodenal wall, allowing EUS-guided choledochoduodenostomy (EUS-CDS). In view of malignant distal biliary obstruction, altered anatomy and difficult duodenal access, EUS -CDS to be performed for internal biliary drainage.
A technically challenging case demonstrating the important role of therapeutic EUS as an alternative approach to biliary drainage when conventional ERCP access is difficult.
