DAVE Project – Gastroenterology

Truptesh H. Kothari, MD, Lenox Hill Hospital
David H. Robbins, MD, Lenox Hill Hospital

Patient is a 27 year old female presents to endoscopy suite for colonoscopy for evaluation of rectal bleeding. Patient denies abdominal pain, fever, chills, nausea, vomiting, bowel – bladder complaints.Patient denies history of surgery and family history of GI cancers or polyps. On physical examination, found to be normal with normal vital s [...]

Bhavesh B. Shah, MD, University of Massachusetts College of Medicine
Jason Wong, MD, University of Massachusetts College of Medicine
Kanishka Bhattabcharya, MD, University of Massachusetts College of Medicine

Our patient is a 31 year-old woman with Peutz-Jeghers Syndrome, a history of GI bleeding and multiple abdominal surgeries who had a video capsule endoscopy for surveillance of her small bowel. At two hours and 13 minutes into her study, video capsule endoscopy revealed a large pedunculated polyp, seen here in the distal small bowel; this was l [...]

Sohail N. Shaikh, MD, Brigham and Women’s Hospital
Marvin Ryou, MD, Brigham and Women’s Hospital
Dan E. Azagury, MD, Brigham and Women’s Hospital
Christopher C. Thompson, M.D., Brigham and Women’s Hospital

Gastrointestinal bleeding is an ominous complication associated with 5-10% mortality. Various methods have been developed for endoscopic control. (pause) Clips, cautery, APC, and injection therapy have been useful with good efficacy. Using principles established by these tools future devices may better address current limitations by enhancing [...]

Michael Babineaux, MD, University of Texas Medical Branch
Gabriel Lee, MD, University of Texas Medical Branch
Andrew W. DuPont, M.D., University of Texas Medical Branch

A 30 year old woman with Peutz-Jegher syndrome presented with nausea, vomiting and crampy left abdominal pain. She had undergone multiple abdominal surgeries since child hood for intussuception of the small bowel due to large hamartomatous polyps. Her physical exam was remarkable for tachycardia, hyperpigmented spots on her lips and an abdomen ten [...]

Jonathan Buscaglia, MD, Stony Brook University Medical Center

On routine examination of the cecum during screening colonoscopy, a 76 year-old man is noted to have a small amount of polypoid tissue extruding from the appendiceal orifice. The lesion is submerged in water and a 20 MHz, high-frequency, EUS probe is used for further evaluation. EUS allows for easy sonographic identification of the polyp. The brig [...]

Chandra S. Dasari, MD, MD Anderson Cancer Center
Gottumukkala S. Raju, MD, MD Anderson Cancer Center

The following video demonstrates the medical management of total gastrectomy with esophagojejunostomy. These are the two different types of esophago jejunostomies. This is a simple Roux-en-Y esophagojejunostomy. It has a short blind loop and a patent loop of jejunum. We will now see the endoscopic view of a simple Roux-en-Y esophagojejunostomy i [...]

Nonthalee Pausawasdi, MD,

This is a case of a 71 year-old woman with past medical history of peptic ulcer disease status post Billroth II. She presented with a 3-month history of acute recurrent pancreatitis, postprandial pain, and nausea. Her CT abdomen showed markedly dilated fluid filled proximal jejunum and duodenum. Gallbladder, bile ducts, and pancreatic duct were dil [...]

Shinsuke Kiriyama, MD,

We experienced endoscopic submucosal dissection using magnetic anchor for early gastric cancer. Endoscopic submucosal dissesection has been accepted as a superior treatment because it has many advantages, which are high en-bloc resection rate, low local recurrence rate and accurate histological staging. On the other hand, ESD has some disadvantage [...]

Evan S. Dellon, MD, University of North Carolina
Field Willingham, MD, MPH, Massachusetts General Hospital
Chad P. Soupir, MD, Massachusetts General Hospital
Hani Y. Abdallah, MD, Beth Israel Deaconess Medical Center
Courtney E. Barancin, MD, University of Wisconsin Hospitals and Clinics
Jonathan M Buscaglia, MD, Johns Hopkins Medical Center
Alejandra I. Castillo-Roth, MD, SUNY Downstate Medical Center
Christopher J. DiMaio, MD, Brigham and Women’s Hospital
Daniel K. Mullady, MD, Brigham and Women’s Hospital, Massachusetts General Hospital
Gottumukkala S. Raju, MD, MD Anderson Cancer Center

A 76 yo W presented with 6 months of intermittent abdominal pain and a 50 pound weight loss. Her symptoms would recur and relapse. She had recently moved from Albania and presented to the MGH ED. For the initial evaluation, she underwent an abdominal CT scan. There were three findings. First, pneumobilia was demonstrated. Second, there were f [...]

Marilena E. Riccioni, MD, Catholic University, Rome
Enrico C. Nista, MD, Catholic University, Rome
Riccardo Urgesi, MD, Catholic University, Rome
Cristiano Spada, MD, Catholic University, Rome
Pietro Familiari, MD, Catholic University, Rome
Guido Costamagna, MD, Catholic University, Rome

Preparation of instruments and accessories needed for push and pull enteroscopy. The prototype of the single balloon enteroscopy system (Olympus Tokyo Japan) consists of a high resolution enteroscope long 2 meters with a 2.8 mm accessory channel, and a extremely flexible transparent overtube with a latex balloon attached on its distal part. [...]