DAVE Project – Gastroenterology

Jonathan M Buscaglia, MD, Johns Hopkins Medical Center

A 72 year-old man is found to have a rectal adenocarcinoma on screening colonoscopy. CT scan of the abdomen and pelvis is performed and shows evidence of rectal wall thickening without associated lymphadenopathy. Subsequent PET scan shows increased activity in the rectum only. Staging pull-through EUS examination is then performed. Radial imaging a [...]

B. Joseph Elmunzer, MD, University of Michigan
Amaar Ghazale, MD, University of Michigan
Akbar K. Waljee, MD, University of Michigan
Craig M. Womeldorph MD, University of Michigan

The patient is a 61 year-old gentleman with multiple medical problems, including end stage renal disease requiring a deceased donor kidney transplant, who developed walled-off pancreatic necrosis four months after an episode of severe gallstone pancreatitis. He developed progressive anorexia, early satiety, and post-prandial nausea, leading to [...]

Srikrishna Vemana, MD, University Hospitals Case Medical Center

We would like to start by presenting a rare case of gastrointestinal bleeding post combined kidney-pancreas transplantation. This is a 43 y/o male with a history of kidney-pancreas transplantation in 2002 and failed graft functioning over time. He was seen several weeks prior to presentation at our institution with hematochezia. He had an upper [...]

Todd H. Baron, M.D., Mayo Clinic

The patient presented with a large impaction of a stone in the sigmoid colon. Endoscopically an electrohydraulic lithotripter device was used under saline irrigation in attempt to fragment the stone. Here you can see fragmentation of the stone. Large diverticula can be seen which were the cause of the stone impaction in the sigmoid colon. A large n [...]

Harry Aslanian, M.D., Yale University
Catherine McCrann, MD, Yale University

A 55 year old male recently discharged from the hospital after treatment for sepsis due to post-obstructive pneumonia related to lung cancer, and a DVT treated with Lovenox , developed hematochezia with passage of blood clots. Sigmoidoscopy at presentation revealed a large, nearly circumferential rectal ulcer, with islands of normal appearing inte [...]

Gottumukkala S. Raju, MD, MD Anderson Cancer Center

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Mark Anthony A. De Lusong, MD,

Anastomotic strictures after colorectal resection are not uncommon, and may complicate colorectal surgery in up to 8% of patients. Depending on the location and clinical symptoms, treatment options may include: (1) medical management with stool softeners and laxatives- which might suffice for mild strictures (2) endoscopic dilation or (3) surgica [...]

Yutaka Saito, MD, PhD, National Cancer Center Hospital, Japan

Introduction Endoscopic submucosal dissection (ESD) for colorectal cancer is not widely accepted because of its technical difficulty and the greater risk of perforation. The en-bloc resection rate using ESD has been reported to be considerably higher compared to conventional endoscopic mucosal resection (EMR), but the perforation rate for ESD also [...]

Yutaka Saito, MD, PhD, National Cancer Center Hospital, Japan

Background: We previously reported on the safety and usefulness of the bipolar current needle knife (B-Knife) for colorectal endoscopic submucosal dissection (ESD) Therefore remains a slight risk of perforation, however, so we developed a B-knife with a ball shape tip at the end of the needle which further reduces the risk of perforation. Objec [...]

Omkar Dave, B.S., University of Texas Medical Branch
Gottumukkala S. Raju, MD, MD Anderson Cancer Center

We will demonstrate the retention of resolution clips on a colorectal polypectomy site. One significant complication of colorectal polypectomy is acute or delayed postpolypectomy hemorrhage. Large polyps in the proximal colon, especially >1 cm, carry the greatest risk of postpolypectomy hemorrhage. Hemoclips have been shown to be very effective [...]