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Case Studies2019-06-26T00:04:26-07:00
Zoom endoscopy combined with Narrow Band Imaging (NBI) of the nodular area (yellow circle). Note the raised mucosa, aberrant crypts and corkscrew vessels suggestive of dysplasia

Barrett’s Esophagus Case Study 1: Intestinal Metaplasia

A 62-year-old male presented with complaints of daily heartburn and chest discomfort. These symptoms had been ongoing for seven to eight years but had worsened over the last few months. He underwent an upper endoscopy and Barrett's esophagus was diagnosed.

See the Outcome
Circumferential Radiofrequency Ablation (RFA) of the lower esophagus

Barrett’s Esophagus Case Study 2: Low-Grade Dysplasia

A 59-year-old male was diagnosed with Barrett's esophagus five years ago. On his last surveillance endoscopy, random biopsies of Barrett's mucosa showed low-grade dysplasia. The patient was referred to IESMG for further evaluation and treatment.

See the Outcome
Barrett's-mucosa

Barrett’s Esophagus Case Study 3: High-Grade Dysplasia

A 66-year-old white male was diagnosed with Barrett's esophagus. Endoscopy and biopsies showed an area of nodular high-grade dysplasia. At IESMG, he underwent endoscopic mucosal resection (EMR) of the nodular area with success. He is now considered for ablation of residual Barrett's esophagus.

See the Outcome
Nodular lesion along a "tongue" of Barrett's mucosa.

Barrett’s Esophagus Case Study 4: Barrett’s with Focal Carcinoma-In-Situ

A 78-year-old male ex-smoker with emphysema and a long-standing history of GERD was found on upper endoscopy to have Barrett’s esophagus with a focal area of raised mucosa. A 1 cm nodular lesion was identified along a “tongue” of Barrett’s mucosa.

See the Outcome
Circumferential Barrett's mucosa along the distal esophagus.

Barrett’s Esophagus Case Study 5: Barrett’s with Multifocal High-Grade Dysplasia

A 63-year-old male with chronic GERD was diagnosed to have circumferential Barrett’s involving a 4 to 5 cm segment of the distal esophagus. Biopsies showed high-grade dysplasia, confirmed by a second pathologist.

See the Outcome
Large multilobulated gastric varix in the fundus

Cyanoacrylate Treatment of Gastric Varices Case Study 1: Recurrent Gastrointestinal Bleeding

A 60-year-old man with cirrhosis secondary to alcoholic liver disease presented with a history of multiple gastrointestinal bleeds over a three-year period. The patient had a history of both esophageal and gastric varices and had undergone multiple episodes of esophageal variceal band ligation.

See the Outcome
Large gastric varix

Cyanoacrylate Treatment of Gastric Varices Case Study 2: Gastric Varices with Portal and Splenic Vein Thrombosis

An 80-year-old male with a history of multiple endocrine neoplasia type 1 presented to an outside hospital with burgundy stool. He had a history of gastric varices secondary to thrombosis of the portal and splenic veins.

See the Outcome
Same varix after glue injection

Cyanoacrylate Treatment of Gastric Varices Case Study 3: Acute Gastric Variceal Bleeding After Surgical Shunt

A 71-year-old male with cryptogenic cirrhosis and hepatocellular carcinoma was transferred from an outlying hospital with acute GI bleeding. He underwent portal decompressive surgery one year earlier for variceal bleeding.

See the Outcome
Endoscopic ultrasound

Cyanoacrylate Treatment of Gastric Varices Case Study 4: Bleeding Duodenal Varices

A 42-year-old male with a history of necrotizing biliary pancreatitis complicated by splenic vein thrombosis presented with episodic transfusion-dependent melena. Multiple upper and lower endoscopies, RBC tagged scans, and small bowel radiographs were unrevealing of a bleeding source.

See the Outcome
Large sessile adenoma in the duodenum.

Endoscopic Mucosectomy Case Study 1: Flat Duodenal Adenoma

An 83-year-old male with a history of iron deficiency anemia underwent upper endoscopy and was found to have a 3 cm sessile adenoma in the second portion of the duodenum extending over two folds. Biopsies showed tubular adenoma without dysplasia. He was referred to IESMG for consideration of mucosectomy.

See the Outcome
Large adenoma in the sigmoid colon (without chromoscopy).

Endoscopic Mucosectomy Case Study 2: Large Colon Adenoma

A 54-year old female who underwent screening colonoscopy was found to have a 5 cm adenomatous growth encompassing the hemicircumference of the sigmoid colon. Biopsies showed a tubular-villous adenoma. She was referred for mucosectomy.

See the Outcome
  • Barrett’s Esophagus Case Study 1: Intestinal Metaplasia
  • Barrett’s Esophagus Case Study 2: Low-Grade Dysplasia
  • Barrett’s Esophagus Case Study 3: High-Grade Dysplasia
  • Barrett’s Esophagus Case Study 4: Barrett’s with Focal Carcinoma-In-Situ
  • Barrett’s Esophagus Case Study 5: Barrett’s with Multifocal High-Grade Dysplasia
  • Cyanoacrylate Treatment of Gastric Varices Case Study 1: Recurrent Gastrointestinal Bleeding
  • Cyanoacrylate Treatment of Gastric Varices Case Study 2: Gastric Varices with Portal and Splenic Vein Thrombosis
  • Cyanoacrylate Treatment of Gastric Varices Case Study 3: Acute Gastric Variceal Bleeding After Surgical Shunt
  • Cyanoacrylate Treatment of Gastric Varices Case Study 4: Bleeding Duodenal Varices
  • Endoscopic Mucosectomy Case Study 1: Flat Duodenal Adenoma
  • Endoscopic Mucosectomy Case Study 2: Large Colon Adenoma

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