During upper GI endoscopy, the oral cavity and hypophar-ynx are routinely passed and most endoscopists do not pay much attention to potential findings in what might be considered the realm of the ENT (ear-nose-throat) specialist [1,2]. However, clinical and endoscopic interest by dedicated and committed colleagues is rising in this field, and some important, mostly incidental findings have been reported in the literature and are constantly encountered by the "ENT-dedicated" endoscopist. However, although potentially accessible during "esophago-gastro-duodenoscopy" using standard or, even more instrumental to this end, ultra-slim upper endoscopes, gastrointestinal endoscopic visualisation of the posterior nasal cavity, of potential clinical relevance, e.g. in work-up of presumed upper GI bleeding, has not been widely reported in the literature. This is illustrated in an elderly patient undergoing endoscopic retrograde cholangiopancreatography (ERCP) with intended direct cholangioscopy using an ultra-slim upper endoscope for DC-guided electrohydraulic lithotripsy (EHL).
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