Sultan Mahmood MD
@SultanMahmoodMD
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Interventional Endoscopy/ 3rd space Endo @PittGILiverNutr Presby/Passavant. Trained @BIDMC_GI @OUHealth. Creator @Gijournal.
Pittsburgh, PA
Joined March 2012
Gastric cancer is associated w/ significant morbidity and mortality. A very fortunate patient with early gastric cancer T1 on EUS was referred for ESD. Fortunately for him lesion was T1a on final path!. @PittGILiverNutr #gitwitter
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A perfect “cast” of the bile duct in a post transplant pt. Pulled out during ERCP. This was rather soft . How often do you see that ? #advancedendo #ercp #gitwitter
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Congratulations 🎉 to my lovely wife @SultanRutaba on her IM residency graduation 👩🎓! .Really proud of you. You will be an excellent physician. @UBIMResidency
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1/4 . Excited to share our publication ."It's All The RAVE: Time to Give up on “Chronic Radiation Proctitis” Misnomer" published in @AGA_Gastro . 🔗 🙏@stevenbollipo @DocJarad @ScottRSteeleMD Anaya C @kate_oakland Rob Bristow
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Excited to officially launch the 3rd space program at @PittGILiverNutr ! . 12 cm LSL removed en bloc, covering 75% circumference. Apologize for the poor quality pics . 🎥 recording got messed up. #gitwitter
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Thrilled to share that we’ve completed over 50 POEM procedures this week at @PittGILiverNutr and established a strong ESD program. It truly takes a village—I’m incredibly grateful to my mentors, colleagues, reps and the outstanding team at @UPMC for their unwavering support.
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In case someone wants to learn the types of dyssynergia on anorectal manometry. Here is my pnemonic to remember it. #Meded #GIfellows.
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I will be starting my new position as the Social Media Editor for @AGA_CGH . Thanks a lot for the opportunity @AmerGastroAssn . Looking forward to working with some amazing people. #GItwitter #Meded #Gifellows.
Welcome to our new Social Media Editors! @MicroMindy and @SultanMahmoodMD will be sharing content from the @AmerGastroAssn journals and newspaper - be sure to give them a follow!
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Honored to receive the Academic award at #GIfelllws @UBCommunity graduation. Thank you all. Best of luck for your future.
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This is an actual colonoscopy report in the patient chart. Thank God we are not using paper charts anymore.
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Thrilled to embark on my academic journey with @pittgilivernutr! 🎓 . Excited to learn from the best and deliver top-notch care to the wonderful patients in Pittsburgh. 🌟 #Gitwitter. 🙏 @BIDMC_GI for the training and support .@tberzin @Boston_Endo @MoamenGabrMD @MSawhneyMD.
🥳We are thrilled to welcome @SultanMahmoodMD to the @UPMC Interventional Endoscopy Team! We now offer ESD and POEM to patients at @UPMC Passavant, enhancing our commitment to exceptional patient care. 📢Learn more: @UPMC_CTSurgery
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Overwhelmed by the ❤️ & support received at the GI fellowship graduation 2022. Great to see these amazing fellows enter the new phase in their life @mtahirMD #ErinLy #TiberiuMoga . #NavpreetRana
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👏Love the new CPU published in @AGA_Gastro by @RKeswaniMD @seth_crockett @AudreyGIdoc !. My fav part was the inclusion of SSL detection targets for colonoscopy.
Hopeful the GI community will find this focused article helpful in framing their approach to improving the quality and value of screening colonoscopy at their institutions (including us at @NMGastro!) See full article at
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Couldn’t have asked for a better team to spend the last year with. Learned so much in addition to the procedural skills and made some life long friends and mentors! @BIDMC_GI
We could not be prouder of our graduating advanced endoscopy fellows @BIDMC_GI @harvardmed- all already on their way to become leaders in the field. @SultanMahmoodMD (@PittGILiverNutr), @SamIgbinedion (@UTChattanooga), @EHolzwanger (@TuftsMedicalCtr).
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#Gitwitter need your help with this case. Pt with dysphagia (LES stric), large epiphrenic diverticulum (no achalasia) coming in for dilation. EGD with a large impacted piece of plastic. Dilated LES to 20mm. Unable to push it through to the stomach or retrieve it through UES💡
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📢REMSWITCH paper is out on @AGA_CGH !. Switching from IV to sQ infliximab is safe and well-accepted. Good option for patients with potential cost saving? . #gitwitter #mondaynightibd . 🔗
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A very satisfying case at @BIDMC_GI #advancedendo . 🩺Young lady post whipple for ABPJ with abdominal pain found to have abnormal liver enzymes/ LHD stone on MRCP. ERCP with stone at HepatoJ and LHD. CBD was big enough to allow passage of PCF for CHOLANGIOSCOPY 🤯
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Thanks a lot for the opportunity @tberzin !. Excited to work with an amazing team @MSawhneyMD @Boston_Endo .@BIDMC_GI @Harvard.
Heartiest congratulations to our incoming 2022 BIDMC advanced endoscopy fellows: @iamdriggy, @EHolzwanger, and @SultanMahmoodMD. We are all looking forward to help you get launched as colleagues and collaborators in such an exciting field.
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Transnasal endoscopy-- does it have a role in Adult GI practice? .🔗Any experience?.@drkeithsiau @tberzin @stevenbollipo @SunilAminMD . #gitwitter #meded @AGA_CGH
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G-POEM can be an effective treatment for a carefully selected group of patients with refractory gastroparesis. I find the lesser curvature approach faster . #gitwitter @gastrowala @tberzin @PittGILiverNutr @SunilAminMD @MoamenGabrMD
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Best 30 min talk on pancreas cyst @MSawhneyMD @BIDMC_GI . “Daughters get SPN, mothers get MCN and grandmothers get IPMN”
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Patient with severe CBD stricture caused by panc head mass. Failed ERCP. Proceeded with EUS cholecystoduodenostomy. Stent placed successfully but only clear fluid could be seen coming through the stent? . What is going on here? .@EHolzwanger @tberzin @ChahalPrabhleen
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#GIfellows Excellent tips for graduating fellows. Thank you everyone. Tag any graduating fellows you know @BilalMohammadMD @AsadurRahman87 @vaibhav_manu @ijlalakbar @HassaanZiaMD
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Multidisciplinary coordination is the 🔑 to a successful advanced endoscopy program. Combined procedure with interventional cardiology 🫀 , thoracic surgery 🫁 and interventional Gi 💩to manage a complex pt. Any guesses what we are did? . Hint: pt failed endosuturing/otsc
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Hybrid ESD can be a great rescue option for scarred-down polyps and difficult locations. Important to get a good circumferential dissection to bury the snare. Unfortunately, this polyp came back as invasive cancer with high-risk features so the patient eventually needed surgery
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1/4 ⭐️Tweetorial on Empirical dilation for NOD. 👉 Controversial topic with strong opinions on both sides of the aisle .👉We share our publication in @DDS_Journal addressing this .#gitwitter @EsophagusDoc @ijlalakbar @TomMalikowskiMD .🔗
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🔥Exciting new study from @teoh_anthony et al. 👉EUS – guided choledocho-duodenostomy a reasonable first choice option for patients with unresectable malignant distal biliary obstruction. @AGA_CGH @AGA_Gastro #gitwitter .🔗
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Who said hair don't grow in the colon. Rare case of Primary teratoma in the colon published in @AGA_CGH
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Thank you for your kind words @jdpicano (graduating Chief fellow) @UBIMResidency . #AcademicTwitter #gitwitter #gifellows .Joys of academic medicine
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62 yo F w/ diarrhea. labs with AKI, high CRP, ANCA, negative infectious workup. started on steroids but returns later with hemoptysis. Unifying etiology? . 🔗
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Why are there no emojis for GI organs ? . Are we being left out ? . #gitwitter . @ebtapper @AtoosaRabiee @BilalMohammadMD @drkeithsiau @RashidLui @KM_Pawlak @AllonKahn @PopovVioleta @DCharabaty
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As the graduation day approaches, I was thinking about compiling."Tips for Graduating GI fellows ". I will start with one . 1) Write name of snare, peg tube, hemoclips that you like . Makes it easier to request it at your new job. @ZachSmithGI @ChahalPrabhleen @MTPapaD.
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An excellent review on the role of antireflux surgery published in @AGA_CGH by Vivek Kaul. 10 things every Gastroenterologist should know. 🤯"A total of 82.6% of patients resume their original PPI prescription within 15 years of antireflux surg".
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>40% prevalence of FGID in majority of the industrialized nations! . #Gifellows get comfortable managing these !.
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Let the "intermittent fasting" begin. Happy Ramadan to all my friends celebrating. Let's take a moment to count our blessings and thank 🙏 all our family and friends.
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Pt coming in for ercp with CBD stricture 2/2 metastatic pancreatic cancer. Found to have a moderate duodenal stricture, ercp scope could traverse . JF-140 scope to the rescue, procedure completed safely without the need for dilation or ptbd. Anyone have this scope ? #gitwitter
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Thought provoking article from @AGA_CGH . “Up-front endoscopy maximizes cost-effectiveness and cost-satisfaction in uninvestigated dyspepsia”. Early endoscopy for dyspepsia a reasonable approach ? . 🔗
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3/4.➡️Using this misnomer leads to unnecessary focus on anti inflx medication which are unlikely to work.➡️We suggest using the more appropriate term Radiation associated vascular ectasias (RAVE) for all vascular ectasias seen after ch. RT.
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Diagnostic paracentesis by IM residents? Do we always need US? . #Livertwitter @AtoosaRabiee @ebtapper.
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#gitwitter #ddw2022 taking 6 biopsies instead of 4 doubles the yield of Celiac disease. In bulb highest yield is at the “dependent area” at 9 and 12oclock position @ASGEendoscopy
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3rd RCT on Ac uncomplicated diverticulitis fails to show any benefit of antibiotics. @AGA_CGH .👉Multi-center placebo controlled trial.👉180 pts randomized.👉Hospital stay (A40.0 vs P45.8hrs).👉Ad events (A12% vs P12%).👉Readmission 7d/30d (not diff).
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Congratulations @shailsingh @ShyamTMD on a successful WISE interventional endoscopy conference near Pittsburgh ! .Excellent faculty and live cases. Great opportunity to connect with friends and colleagues. We see you back there @SighPichamol 🤣
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Patient with a h/o cholelithiasis comes in with abdominal pain , labs show T bili 3.8, mild elevation in AST ALT AP, Liver US with dilated CBD at 1 cm. MRCP is obtained and reported -ive. However, after 3 days T bili remains elevated at 3.4.
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@tberzin @BIDMC_GI @SamIgbinedion @EHolzwanger What a way to start ! . Colon stent, duodenal stent , ercp w/precut and so much more ! Excited to work with this amazing team this year
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When the reason for the consult is evaluate and treat and pt doesn’t know why he’s here. 🕵️
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Excited to moderate the @SAGES_Updates Flexible Endoscopy course 2021! . Good to see in person educational activities resuming. Also got to meet the amazing #Vivekkaul !
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DOI: 10.1016/j.cgh.2019.10.035. Positioning therapies for Crohns disease published in @AGA_CGH.@AmerGastroAssn . Haven't used Sulafalazine for CD but seems to be a reasonable option for low risk patients with colon dominant disease. @DCharabaty @IBD_Afzali @ibdtweets
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Doesn’t matter how busy it gets, still time for a morning didactic session ! . Did you know that the first cholagiopancreaticogram was performed by a radiologist at @BIDMC_GI . Imagine cannulating the ampulla using just flouro 🤯. #gitwitter
6/ BIDMC has a rich history in advanced endo w/ a long list of ‘1sts’, including 1st per-oral cannulation with cholangiography (by two radiologists at Beth Israel in 1965!), to more recently the 1st Spyglass digital cholangioscopy & 1st deep learning AI colonoscopy in U.S.
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Unbelievable breakthrough. this can change the practice of medicine and transplant as we know it ! . Is Liver next ?. #livertwitter #gitwitter.
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Higher induction regimen (adalimumab 160 mg at weeks 0, 1, 2, and 3) was not superior to standard induction regimen in patients with moderate to severe CD. SERENE CD Trial Results. 🔗@AmerGastroAssn @AGA_Gastro #gitwitter #meded
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An important study in @AGA_Gastro by Dr Rex addressed the benefit of AI in high detecting (~50% ADR) endoscopists. They still saw a 8% increase in ADR to a 🤯 60.6%. Interestingly some large lesions especially SSLs were missed by AI software. Room for improvement? . #Gitwitter
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Gene therapy has the potential to revolutionize modern medicine. Gastroenterology and especially Hepatology will likely see a number of applications in the coming years. Really enjoyed reading this article from @AGA_Gastro . #gitwitter @AGA_CGH .
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Proud of our @UBCommunity @UBIMResidency GI fellowship program with 7 posters being presented including 4 posters of distinction. @Jeff_Lackner @mtahirMD @muddasir_ayazMD @YouseffazelMD
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Amazing how the colon heals. 12 cm rectal polyp on follow-up after ESD with a 3 cm scar. Normal biopsies
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🔥 New CPU from @AGA_CGH @AmerGastroAssn addresses management of early complications after bariatric/metabolic surgery. 🔗
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It’s time like these that makes everything seems worth it. A few extra minutes in the recovery area can go a long way . #gitwitter #gifellows
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EGD for dyspepsia in a 50 y/o female shows this lesion in D2, ~1cm flat polyp. What would you do? #polypthursday . 1. remove w/lift snare.2. biopsy and decide based on path.3. no biopsy, reschedule to remove lesion
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Hosted the 2nd Gi jeopardy competition! . Despite a tough competition “Poor preps” out smarted “FOBT++” and “No Mercy Hospital” . #gitwitter @UBIMResidency @UBuffalo_GI @mtahirMD @GI_Zo_MD
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You get a referral from an OSH for a failed colonoscopy because of a "tortuous colon". A pediatric colonoscope was used during the failed procedure. What scope do you start off with? #gitwitter .#gifellows.
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@stevenbollipo @WalterChanMD @AllonKahn @magnushallandMD @BMoshiree @john_damianosMD @ZubairMalik_MD @RomeGastroPsych @AdvaniRashmiMD @drkeithsiau Thank you @UpToDate for including the new nomenclature RAVE/radiation proctopathy for radiation proctitis. @stevenbollipo @DocJarad @achoud72 @ScottRSteeleMD @kate_oakland
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1/2 AGA @AGA_Gastro CPU on management of recurrent ac and ch pancreatitis . 👉workup Rec AP➡️EUS > MRI/MRCP .👉❓role of ERCP in divism. Minor ✂️ dilated dorsal PD, santorinicele.👉🛑ERCP in rec ac pancreatitis. ❓biliary sph ✂️. @elmunzer @DennisYangMD .🔗
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If patients received both doses of covid vaccine, should they still be checked for covid before endoscopy ? Need guidance for our GI societies . @AmerGastroAssn @ASGEendoscopy @AmCollegeGastro @BrennanSpiegel @SeragHashem @mikewallacemd @SultanShazi @SunilAminMD.
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👉In the real-world setting, Ustekinumab dose escalation was effective in achieving response in CD pts ( 55% of pts w/ inadequate response or loss of response). @GiJournal @AGA_CGH @AGA_GIHN #gitwitter . 🔗
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Submucosal lesion next to appendix on colonoscopy. Bite on Bite biopsy showed this finding. Interesting case published in @AGA_CGH .
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@NeenaSAbrahamMD @DrHarryThomas @DrBloodandGuts @AustinGastro @DDWMeeting @bhavemann @AllonKahn @DCharabaty @DVinsard @BilalMohammadMD @Samir_Grover @SophieBalzoraMD @joshsteinbergMD @MN_GIMD So glad to finally meet all of my fav #gitwitter ⭐️
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Impressive improvement in need for 🔪 in patients with IBD since 2000. Can largely be attributed to the availability of better medications and treat to target approach. @AGA_CGH @AmerGastroAssn .
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Really enjoyed the company, food and CME session at the annual @KEMCAANA1 retreat. Got a chance to talk about social media for #MedEd. Helped setup Twitter account for some our senior members too 😁. Thanks @TomTielleman and @BilalMohammadMD for sharing your presentations.
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Got a reference request for a fellow. Sounds about right
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Is there an option to opt out of print copy of GI journals ? @AmCollegeGastro @AGA_CGH @AGA_Gastro @ASGEendoscopy @GIreview @GIE_Journal.
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Resistance testing for H pylori on stool samples as good as gastric samples using NGS. Was listening to the podcast with Dr Graham and @JonathanBuscag1 . Makes sense to do this upfront on all cases and limit💊 use .#gitwitter @AGA_Gastro .
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Congrats to our @BIDMC_GI physicians for making it to the Boston’s Top Doctor List ! . @tberzin @Boston_Endo @MSawhneyMD
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📢We are planning a combined journal club with @GIPathJC on May 12th @8pm EST! We will have an all ⭐️panel of GI Pathologists as experts and our very own @GI_Pearls will be moderating the session. If you have any articles/ clinical Qs you would like to discuss, let us know.
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#GItwitter any tricks to get this migrated PD stent out? 4cm x 5 single pigtail stent . There is a 5F 11mm extraction balloon alongside it to give an idea bout the trajectory of PD. Couldn’t pull it out with an extraction balloon. Forceps wouldn’t make the turn.
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If you are a #GIfellow learning colonoscopy or an academic attending assessing colonoscopy skills, please join the conversation this Wednesday on @GiJournal #GIjc. This would be a nice fup from @ScopingSundays discussion on difficult colons.
This Wednesday 5/13/20 @9pm EST we will be discussing the @AmCollegeGastro @AJG article on "DOPS for Evaluating Competency in Colonoscopy" by our #GITwitter 🌟@drkeithsiau. The amazing @Samir_Grover will be our expert commentator. Please join us.
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Delaying colonoscopy more than 12 months after a + FIT test associated with increased CRC risk. Especially important considering hesitancy to undergo colonoscopy during COVID. Time to educate patients and PCPs. @AGA_Gastro @samirguptaGI @drfolamay .DOI:
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Looks like Orise gel @bostonsci is getting recalled. Remember our discussion on @gijournal with @GIPathJC a year ago on this issue. @GI_Pearls @SunilAminMD @ChahalPrabhleen @neilRsharmaMD @Srisha_Hebbar @AustinChiangMD @DrHarryThomas @tberzin .
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My daughter after getting training wheels off yesterday had been looking at BMX stunt videos on YouTube. Kind of reminds me of first year fellows after their first polypectomy looking at ERCP videos. #GIfellows #meded.
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Extra intestinal manifestation of IBD . Which ones have you seen? . I haven’t seen any (that I know of) ophthalmic, pulmonary complications . @AmerGastroAssn @AGA_Gastro @IBDMD @doc_ibd @ibddocmaria @ibdtweets @DCharabaty.
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Excellent case with @MoamenGabrMD @BIDMC_GI . Large ascending colon polyp covering 75% of the circumference (7cm x 4 cm). Tattoo at the base from the previous colonoscopy. ✂️EMR with aid of Dilumen device. 📎Closed with @bostonsci mantis clips. #gitwitter
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C.O.V.I.D.: A Survival Guide for GI Fellowship Training During the COVID-19 Pandemic . #Gifellows @GiJournal @ScopingSundays @MondayNightIBD.
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