DAVE Project – Gastroenterology

Christian Jackson, MD, Loma Linda VA Medical Center
Matthew Oman, MD, Loma Linda VA Medical Center

An 82-year-old male with a history of coronary artery disease, obesity, and atrial fibrillation on chronic anticoagulation with warfarin presented to the emergency department with melena. He denied any abdominal pain, nausea, vomiting, hematemesis, or lightheadedness. He does have chronic pain and ran out of his acetaminophen/hydrocodone and subs [...]

Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano, MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center

Colon cancer prevention series: we would like to share with you endoscopic mucosal resection of a flat lesion in the cecum. Here is a 62 year old man who was recently diagnosed with prostrate cancer. He was referred to us for colonoscopy. He had two large sessile serrated adenomas removed earlier. He came in for removal of additional lesions. In th [...]

Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano, MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center

In this colon cancer prevention series, we would like to show you a flat lesion and its removal using endoscopic mucosal resection technique. A 70-year-old man with prior colon cancer resection and negative colonoscopies on several occasions came in for surveillance examination. As you can see here, there is a flat lesion evidenced by a red patch a [...]

Gottumukkala S. Raju, MD, MD Anderson Cancer Center
Liben Mahometano, MD Anderson Cancer Center
Asif Rashid, MD, PhD, MD Anderson Cancer Center
Patrick Lynch, MD, MD Anderson Cancer Center

In this series on colon cancer prevention, we would like to show some subtle lesions in colon. Here you see a flat lesion identified by the vessel cut-off sign. After injection of submucosal saline, you could identify the lesion a little bit better. Notice the changes in the surface mucosal pit pattern compared to the normal surrounding area &#8211 [...]

Suresh Pola, MD, University of California San Diego, Veterans Affairs San Diego Medical Center

A 56 year-old man was referred for colonoscopy after experiencing three months of watery diarrhea and crampy abdominal pain. He denied fevers or chills, hematochezia, recent travel, sick contacts, or recently taking antibiotics. His primary care physician referred him for colonoscopy after he was found to have a leukocytosis of 15,200 with 70% ne [...]

Patrick Yachimski, MD, Vanderbilt University Medical Center

A 55 year old male was referred for colonoscopy. His medical history was notable for metastatic melanoma, for which he had recently begun therapy with ipilimumab, a monoclonal antibody directed against cytotoxic T lymphocyte antigen 4. Within several days of initial infusion, he experienced onset of profuse watery diarrhea. Colonoscopy demonstra [...]

Marius Paraoan, MD, Wrightington, Wigan and Leigh NHS Foundation Trust

A 79 years old male patient was referred to our unit for laparoscopic resection of a small malignant right-sided colonic lesion identified during a previous colonoscopy. A repeat full colonoscopy with intubation of the terminal ileum was performed. During withdrawal phase a 2.5 centimetres non-polypoid lesion was identified at the level of the hep [...]

Evan B. Grossman, MD,

A 50 year old man has a past medical history of bilateral congenital glaucoma causing him to be legally blind and metastatic rectal cancer to the liver. The patient's cancer was diagnosed because he had developed rectal obstruction. As a result, he underwent a diverting transverse loop colostomy. The patient had difficulty managing his ostom [...]

Dimitri Coumaros, MD, University Louis Pasteur, Strasbourg, France

We report the case of an endoscopic submucosal dissection of a granular type adenoma spreading over eight tenths of the rectum, and sparing a healthy strip of the posterior rectal aspect, in a 75-year-old man, using an electrosurgical endo-knife with a water-jet function, the Flush-knife.. Here we can see through both a direct and retroflex view [...]

Mankawal S. Sachdev, MD,

This was a 30 year-old Caucasian-American male who had a past medical history that was significant for community acquired pneumonia and migraines. He presented to the clinic with a chief complaint of dysphagia for solids and weight loss. Chest x-rays both of the PA and lateral view were negative and without lymphadenopathy. A CT scan of the thorax [...]