Susana Escalante-Glorsky

Interests

Teaching

General clinical gastroenterology with an interest in inflammatory bowel disease

Courses

No activities entered.

Scholarly Contributions

Journals/Publications

• Mir, F. F., Badar, H., Shafiq, M., Varghese, J., Chhabra, R., Hamid, F., Escalante-glorsky, S., Kim, J., Alba, L., Albadarin, S., Bownik, H., Jonnalagadda, S. S., Campbell, D. R., Clarkston, W. K., & Helzberg, J. H. (2018). Longer Retroflexion Duration Significantly Improves Adenoma Detection Rate in the Right Colon: A Multicenter Prospective Pragmatic Clinical Trial: 182. The American Journal of Gastroenterology, 113(Supplement), S103. doi:10.14309/00000434-201810001-00182
• Escalante-glorsky, S., Leichus, L., Raijman, I., Ramsey, G., Pallentino, J., & Posey, J. (2008). Nitazoxanide for the Empiric Treatment of New Onset Diarrhea in Patients with IBD and IBS: 1060. The American Journal of Gastroenterology, 103, S414. doi:10.14309/00000434-200809001-01060
• Moulis, H., Escalante-glorsky, S., Raijman, I., & Leichus, L. (2008). Nitazoxanide for the Empiric Treatment of Persistent Diarrhea: 280. The American Journal of Gastroenterology, 103, S108. doi:10.14309/00000434-200809001-00280
• Escalante-glorsky, S., Khandawalla, H., Navarrete, C., Raijman, I., & Catalano, M. F. (2004). Is There a Different Outcome Between Endoscopic Treatment of Intrahepatic (IHBL) Versus Extrahepatic Biliary Leak (EHBL). Gastrointestinal Endoscopy, 59(5), P181. doi:10.1016/s0016-5107(04)00851-x
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  Is There a Different Outcome Between Endoscopic Treatment of Intrahepatic (IHBL) Versus Extrahepatic Biliary Leak (EHBL)? Susana Escalante-Glorsky, Hashim Khandawalla, Claudio Navarrete, Marc Catalano, Isaac Raijman Sr. Introduction: Endoscopic stenting with or without sphincterotomy is the optimal non-surgical therapy for BL. Placing a short stent in the bile duct without bypassing the leak may be enough for healing. The validity of this statement in IHBL is unknown. We compared the outcome of pts with IHBL with that of EHBL after endoscopic therapy. Patients andMethods: EHBLwas defined as that located below the biliary confluence. A total of 233 pts with BLwere treated. In the IHBL group, there were 27 pts: 3 with right hepatic duct (RHD) leak, 12 duct of Luschka leak, 4 left hepatic duct (LHD) leak, and 8 intrahepatic leaks posttrauma. Of the post-traumatic BL (5 left lobe, 3 right lobe). The mean time from injury to diagnosis of the BL was 4 days. In the EHBL, there were 206 pts. The BL was at the cystic stump in 198 and from an OLT anastomosis in 8. The mean time from surgery to diagnosis of the BL was 4 days. Treatment included a biliary sphincterotomy and placement of a 7-10 Fr straight polyethylene stent bypassing the site of leakage or in the leaking intrahepatic duct. A 7 Fr stent was used in 3 pts with peripheral IHDL and the stent was placed just above the ampulla. Results: Of the pts with EHBL, the BL resolved in 194 of 206, for an overall success rate of 94%. Failures included 1 post-OLT and 11 post-LC. Complications occurred in 1 pt after OLT who developed cholangitis that resolved promptly after therapy, acute pancreatitis in 1 pt after LC, and stent migration in 1 after LC. In the IHBL group, the BL resolved in 23 of 27 pts, for an overall success rate of 85%. Failures included 1 pt after right hepatectomy and 3 post-trauma BL who received 7 Fr stents placed just above the ampulla. After the stent was replaced for a 10 Fr into the leaking branch, the BL leak resolved. Thus, overall 26 of 27 pts resolved (96%). During a mean follow up of 23 months, there has been no recurrence of the BL in either patient’s group. Conclusion: 1. Endoscopic therapy with biliary sphincterotomy and stent placement is successful in the majority of pts with IHBL and EHBL; 2. for pts with IHBL, it is recommended that a stent be placed in the feeding bile duct of the leak; 3. Large bore stents (10 Fr) are preferred over smaller stents (7 Fr); 4. Endoscopic therapy is the intervention of first choice in pts with IHBL or EHBL; 5. Surgery is needed when BL does not resolve after endoscopic therapy; 6. A prospective multicenter trial would be useful in establishing the best possible treatment in these pts.
• Raijman, I., & Escalante-glorsky, S. (2004). Is the Complication Rate the Same for Index Versus Repeat Biliary Sphincterotomy. Gastrointestinal Endoscopy, 59(5), P193. doi:10.1016/s0016-5107(04)00897-1
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  Is the Complication Rate the Same for Index Versus Repeat Biliary Sphincterotomy? Isaac Raijman Sr., Susana Escalante-Glorsky Introduction:Much has been written about the complication rate related to biliary sphincterotomy. These reports have primarily included only patients undergoing initial biliary sphincterotomy. There are limited data regarding the outcome in patients undergoing repeat biliary sphincterotomy. Patients and Methods: From 1/2000 to 9/2003, 1210 ERCPwere performed for indications of biliary disease. Of these, 842 pts underwent biliary sphincterotomy. There were 299men, 543women, mean age 58 years. Of these, 372 (44.2 %) were repeat procedures performed for recurrence or incomplete treatment of biliary disease requiring biliary sphincterotomy. Of these, 75 weremen and 297were women,mean age 53 years. Indications for sphincterotomy included: choledocholithiasis in 477, biliary pancreatitis in 42, bile duct stricture in 231, ampullary adenoma in 7, polycystic liver disease in 2 and bile leak in 43 and sphincter of Oddi dysfunction in 40. Of the 372 patients with recurrent or incomplete treatment of biliary disease, indications included: choledocholithiasis in 229, biliary pancreatitis in 6, bile duct stricture in 92, bile leak in 17, SOD in 28. Of the repeat procedures, 287of the index biliary sphincterotomies were performed at another institution. All procedures performed at our institution were done using 30 mm cutting wire sphincterotomes with a 5 mm tip. Sphincterotomies were performed with a cut-tocoagulation ration of 2 to 1. All procedures were performed by experienced biliary endoscopists. Results: Of the 470 pts with index biliary sphincterotomy, complications included acute pancreatitis in 26 pts (5.5%), perforation in 5 (1%), bleeding in 8 (1.7%), aspiration pneumonia in 1 (0.01%). Of the patients with repeat biliary sphincterotomy, complications included: acute pancreatitis in 3 (1%), perforation in 29 (8%), and bleeding in 19 (5%). There was no mortality in either group. Conclusions: 1.The complication rate after biliary sphincterotomy differs between index and repeat procedures; 2.The incidence of perforation and bleeding is significantly increased after repeat sphincterotomy; 3. Acute pancreatitis is significantly decreased as a complication after repeat biliary sphincterotomy; 4. Technical modifications are needed to decrease (hopefully abolish) these complications; 5. A prospective multicenter study with a larger number of patients is warranted.
• Raijman, I., Escalante-glorsky, S., Khandawalla, H., Glorsky, S., & Fischer, C. (2004). Endoscopic Treatment of Pancreatic Ascites. Gastrointestinal Endoscopy, 59(5), P211. doi:10.1016/s0016-5107(04)00966-6
• Chen, Y. K., Abdulian, J. D., Escalante-Glorsky, S., Youssef, A. I., Foliente, R. L., & Collen, M. J. (1995). Clinical outcome of post-ERCP pancreatitis: relationship to history of previous pancreatitis. The American journal of gastroenterology, 90(12), 2120-3.
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  The aim of this prospective study was to evaluate the relationship between clinical outcome of post-ERCP pancreatitis and history of previous pancreatitis.
• Chen, Y. K., Abdulian, J. D., Escalante-glorsky, S., Youssef, A. I., Foliente, R. L., Collen, M. J., Ai, Y., Rl, F., & S, E. (1995). Clinical outcome of post-ERCP pancreatitis: relationship to history of previous pancreatitis.. The American journal of gastroenterology, 90(12), 2120-3.
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  The aim of this prospective study was to evaluate the relationship between clinical outcome of post-ERCP pancreatitis and history of previous pancreatitis..Fifty patients (3.5%) developed procedure-related pancreatitis during the study period. Twenty-one patients had a history of previous pancreatitis (group I), and 29 patients had no history of previous pancreatitis (group II). There were no significant differences between the two groups with regard to age, gender, pancreatic duct injection, acinarization, or type of ERCP procedure. Grading of clinical severity was based on length of hospitalization, presence of pancreatic complications, and need for intervention: mild 28%, moderate 54%, and severe 18%. Four patients (8.0%) had pancreatic complications, but only one patient required surgery. There were no associated mortalities..Patients in group I had a shorter median hospital stay and were less likely to develop severe pancreatitis than patients in group II: 4.0 versus 7.0 days, p = 0.001 and 4.8 versus 27.6%, p = 0.038, respectively..Intralobular and/or periductal fibrosis secondary to prior pancreatitis may limit the degree of ERCP-induced pancreatic acinar damage.
• Chen, Y., Abdulian, J., Youssef, A., Foliente, R., Collen, M., & Escalante‐Glorsky, S. (1995). Clinical Outcome of Post‐ERCP Pancreatitis: Relationship to History of Previous Pancreatitis. The American Journal of Gastroenterology, 90(12). doi:10.1111/j.1572-0241.1995.tb08129.x
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  The aim of this prospective study was to evaluate the relationship between clinical outcome of post‐ERCP pancreatitis and history of previous pancreatitis. Fifty patients (3.5%) developed procedure‐related pancreatitis during the study period. Twenty‐one patients had a history of previous pancreatitis (group I), and 29 patients had no history of previous pancreatitis (group II). There were no significant differences between the two groups with regard to age, gender, pancreatic duct injection, acinarization, or type of ERCP procedure. Grading of clinical severity was based on length of hospitalization, presence of pancreatic complications, and need for intervention: mild 28%, moderate 54%, and severe 18%. Four patients (8.0%) had pancreatic complications, but only one patient required surgery. There were no associated mortalities. Patients in group I had a shorter median hospital stay and were less likely to develop severe pancreatitis than patients in group II: 4.0 versus 7.0 days, /?= 0.001 and 4.8 versus 27.6%, p= 0.038, respectively. In‐tralobular and/or periductal fibrosis secondary to prior pancreatitis may limit the degree of ERCP‐induced pancreatic acinar damage. Copyright © 1995, Wiley Blackwell. All rights reserved
• Escalante-Glorsky, S., Youssef, A. I., & Chen, Y. K. (1995). Torulopsis glabrata-infected pancreatic pseudocysts. Diagnosis and treatment. Journal of clinical gastroenterology, 21(3), 230-2.
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  Torulopsis glabrata, a fungus commensal with the human gastrointestinal tract, so far has not been recognized as a cause of pancreatic sepsis. We report the cases of two patients with pancreatic pseudocysts that became infected with T. glabrata. A 20-year-old woman 6 weeks postpartum had acute gallstone pancreatitis complicated by pseudocyst formation and pancreatic sepsis. Pseudocyst fluid obtained at cystogastrostomy showed a pure culture of T. glabrata. A 52-year-old man with multiple medical problems showed signs of an infected pseudocyst 9 days after he was hospitalized for alcoholic pancreatitis. Computed tomography (CT)-guided aspiration of the the pseudocyst fluid confirmed T.glabrata as the infecting organism. Neither patient had a history of endoscopic or surgical manipulation. Prolonged therapy with broad-spectrum antibiotics and parenteral hyperalimentation were implicated as risk factors, and other possible pathogenic mechanisms were considered. Both patients were treated successfully with a combination of percutaneous or surgical drainage and amphotericin B, which appears to be the most active drug in vitro. The efficacy of other antifungal agents is discussed. In the context of pancreatitis and/or pseudocysts, empiric therapy with broad-spectrum antibiotics should be minimized because it predisposes patients to superinfection by opportunistic pathogens.
• Escalante-Glorsky, S., Youssef, A., & Chen, Y. (1995). Torulopsis glabrata-infected pancreatic pseudocysts: Diagnosis and treatment. Journal of Clinical Gastroenterology, 21(3). doi:10.1097/00004836-199510000-00013
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  Torulopsis glabrata, a fungus commensal with the human gastrointestinal tract, so far has not been recognized as a cause of pancreatic sepsis. We report the cases of two patients with pancreatic pseudocysts that became infected with T. glabrata. A 20-year-old woman 6 weeks postpartum had acute gallstone pancreatitis complicated by pseudocyst formation and pancreatic sepsis. Pseudocyst fluid obtained at cystogastrostomy showed a pure culture of T. glabrata. A 52-year-old man with multiple medical problems showed signs of an infected pseudocyst 9 days after he was hospitalized for alcoholic pancreatitis. Computed tomography (CT)–guided aspiration of the pseudocyst fluid confirmed T. glabrata as the infecting organism. Neither patient had a history of endoscopic or surgical manipulation. Prolonged therapy with broad-spectrum antibiotics and parenteral hyperalimentation were implicated as risk factors, and other possible pathogenic mechanisms were considered. Both patients were treated successfully with a combination of percutaneous or surgical drainage and amphotericin B, which appears to be the most active drug in vitro. The efficacy of other antifungal agents is discussed. In the context of pancreatitis and/or pseudocysts, empiric therapy with broad-spectrum antibiotics should be minimized because it predisposes patients to superinfection by opportunistic pathogens. © 1995 Lippincott-Raven Publishers, Philadelphia.
• Youssef, A. I., Escalante-Glorsky, S., Bonnet, R. B., & Chen, Y. K. (1994). Hemoptysis secondary to bronchial varices associated with alcoholic liver cirrhosis and portal hypertension. The American journal of gastroenterology, 89(9), 1562-3.
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  End-stage liver disease is associated with systemic changes involving many organs. Several pulmonary, tracheal, bronchial, and pleural abnormalities have been described. In this report we describe the first case of hemoptysis secondary to bronchial and lower tracheal varices in a patient with end-stage alcoholic liver disease and portal hypertension, and explore the relationship between tracheobronchial varices and portal hypertension.
• Youssef, A. I., Escalante-glorsky, S., Bonnet, R. B., & Chen, Y. K. (1994). Hemoptysis secondary to bronchial varices associated with alcoholic liver cirrhosis and portal hypertension.. The American journal of gastroenterology, 89(9), 1562-3.
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  End-stage liver disease is associated with systemic changes involving many organs. Several pulmonary, tracheal, bronchial, and pleural abnormalities have been described. In this report we describe the first case of hemoptysis secondary to bronchial and lower tracheal varices in a patient with end-stage alcoholic liver disease and portal hypertension, and explore the relationship between tracheobronchial varices and portal hypertension.