Medical Specialty: Gastroenterology

Specialty that treats diseases and pathology of the gastrointestinal tract, such as the esophagus, stomach and intestinal tract as well as diseases of the liver, gallbladder and pancreas.

Gastroenterology
Abdominal Abscess I&D
Incision and drainage (I&D) of abdominal abscess, excisional debridement of nonviable and viable skin, subcutaneous tissue and muscle, then removal of foreign body.
Abdominal Exploration
Congenital chylous ascites and chylothorax and rule out infradiaphragmatic lymphatic leak. Diffuse intestinal and mesenteric lymphangiectasia.
Abdominal Pain - Consult
The patient presented to the emergency room last evening with approximately 7- to 8-day history of abdominal pain which has been persistent.
Abscess Excision
Excision of abscess, removal of foreign body. Repair of incisional hernia. Recurrent re-infected sebaceous cyst of abdomen. Abscess secondary to retained foreign body and incisional hernia.
Admission History & Physical - Nausea
Patient status post gastric bypass surgery, developed nausea and right upper quadrant pain.
Adrenalectomy & Umbilical Hernia Repair
Laparoscopic hand-assisted left adrenalectomy and umbilical hernia repair. Patient with a 5.5-cm diameter nonfunctioning mass in his right adrenal.
Air Under Diaphragm - Consult
Possible free air under the diaphragm. On a chest x-ray for what appeared to be shortness of breath she was found to have what was thought to be free air under the right diaphragm. No intra-abdominal pathology.
Appendectomy
Appendicitis, nonperforated. Appendectomy. A transverse right lower quadrant incision was made directly over the point of maximal tenderness.
Appendectomy - 1
Acute appendicitis, gangrenous. Appendectomy.
Appendectomy - Laparoscopic
Laparoscopic appendectomy and peritoneal toilet and photos. Pelvic inflammatory disease and periappendicitis.
Appendectomy Laparoscopic
Laparoscopic appendectomy. Acute appendicitis.
Appendectomy Laparoscopic - 1
Laparoscopic appendectomy. Acute suppurative appendicitis. A CAT scan of the abdomen and pelvis was obtained revealing findings consistent with acute appendicitis. There was no evidence of colitis on the CAT scan.
Barium Enema
Barium enema - history of encopresis and constipation.
Barium Swallow Study & Speech Evaluation
The patient was referred for an outpatient speech and language pathology consult to increase speech and swallowing abilities. The patient is currently NPO with G-tube to meet all of his hydration and nutritional needs. A trial of Passy-Muir valve was completed to allow the patient to achieve hands-free voicing.
Barium Swallow Study & Speech Evaluation - 1
Barium Swallow Study Evaluation
Modified Barium swallow study evaluation to objectively evaluate swallowing function and safety. The patient complained of globus sensation high in her throat particularly with solid foods and with pills. She denied history of coughing and chocking with meals.
Barium Swallow Study Evaluation - 1
The patient is a 76-year-old male, with previous history of dysphagia, status post stroke. A modified barium swallow study was ordered to objectively evaluate the patient's swallowing function and safety and to rule out aspiration.
BICAP Cautery
Hematemesis in a patient with longstanding diabetes. Submucosal hemorrhage consistent with trauma from vomiting and grade 2 esophagitis. Mallory-Weiss tear, successful BICAP cautery.
Blood In Toilet
Blood in toilet. Questionable gastrointestinal bleeding at this time, stable without any obvious signs otherwise of significant bleed.
Blood per Rectum
Status post colonoscopy. After discharge, experienced bloody bowel movements and returned to the emergency department for evaluation.
C. Diff Colitis Consult
The patient is a very pleasant 72-year-old female with previous history of hypertension and also recent diagnosis of C. diff, presents to the hospital with abdominal pain, cramping, and persistent diarrhea.
Cecal Polyp Resection
Laparoscopic resection of cecal polyp. Local anesthetic was infiltrated into the right upper quadrant where a small incision was made. Blunt dissection was carried down to the fascia which was grasped with Kocher clamps.
Cholangiocarcinoma Consult
Newly diagnosed cholangiocarcinoma. The patient is noted to have an increase in her liver function tests on routine blood work. Ultrasound of the abdomen showed gallbladder sludge and gallbladder findings consistent with adenomyomatosis.
Cholecystectomy - Open
Open cholecystectomy (attempted laparoscopic cholecystectomy).
Cholecystectomy & Cholangiogram.
Laparoscopic cholecystectomy with cholangiogram.
Cholecystectomy Laparoscopic
Laparoscopic cholecystectomy. Gallstone pancreatitis. Video laparoscopy revealed dense omental adhesions surrounding the gallbladder circumferentially.
Cholecystitis - Discharge Summary
Cholecystitis with choledocholithiasis. Laparoscopic cholecystectomy with laparoscopy converted to open common bile duct exploration and stone extraction.
Cholecystostomy Tube Placement
Placement of cholecystostomy tube under ultrasound guidance. Acute acalculous cholecystitis.
Clostridium Difficile Colitis Followup
Still having diarrhea, decreased appetite.
Colon Cancer Consult
Newly diagnosed stage II colon cancer, with a stage T3c, N0, M0 colon cancer, grade 1. Although, the tumor was near obstructing, she was not having symptoms and in fact was having normal bowel movements.
Colon Cancer Screening
Routine colorectal cancer screening. He occasionally gets some loose stools.
Colon Polyps - Genetic Counseling
Genetic counseling for a strong family history of colon polyps. She has had colonoscopies required every five years and every time she has polyps were found. She reports that of her 11 brothers and sister 7 have had precancerous polyps.
Colonoscopy
Iron deficiency anemia. Diverticulosis in the sigmoid.
Colonoscopy - 1
Colonoscopy due to rectal bleeding, constipation, abnormal CT scan, rule out inflammatory bowel disease.
Colonoscopy - 10
Colon cancer screening and family history of polyps. Sigmoid diverticulosis and internal hemorrhoids.
Colonoscopy - 11
Colonoscopy. The Olympus video colonoscope was inserted through the anus and was advanced in retrograde fashion through the sigmoid colon, descending colon, around the splenic flexure, into the transverse colon, around the hepatic flexure, down the ascending colon, into the cecum.
Colonoscopy - 12
Colonoscopy. The Olympus video colonoscope then was introduced into the rectum and passed by directed vision to the cecum and into the terminal ileum.
Colonoscopy - 13
History of polyps. Total colonoscopy and photography. Normal colonoscopy, left colonic diverticular disease. 3+ benign prostatic hypertrophy.
Colonoscopy - 14
Colonoscopy. History of colon polyps and partial colon resection, right colon. Mild diverticulosis of the sigmoid colon. Hemorrhoids.
Colonoscopy - 15
Colonoscopy. Change in bowel habits and rectal prolapse. Normal colonic mucosa to the cecum.
Colonoscopy - 16
Colonoscopy. Rectal bleeding and perirectal abscess. Normal colonoscopy to the terminal ileum. Opening in the skin at the external anal verge, consistent with drainage from a perianal abscess, with no palpable abscess at this time, and with no evidence of fistulous connection to the bowel lumen.
Colonoscopy - 17
Universal diverticulosis and nonsurgical internal hemorrhoids. Total colonoscopy with photos. The patient is a 62-year-old white male who presents to the office with a history of colon polyps and need for recheck.
Colonoscopy - 18
Possible inflammatory bowel disease. Polyp of the sigmoid colon.. Total colonoscopy with photography and polypectomy.
Colonoscopy - 19
Colonoscopy with terminal ileum examination. Iron deficiency anemia. Following titrated intravenous sedation the flexible video endoscope was introduced into the rectum and advanced to the cecum without difficulty.
Colonoscopy - 2
Colonoscopy in a patient with prior history of anemia and abdominal bloating.
Colonoscopy - 20
Screening colonoscopy. Tiny polyps. If adenomatous, repeat exam in five years.
Colonoscopy - 21
Colonoscopy and biopsies, epinephrine sclerotherapy, hot biopsy cautery, and snare polypectomy. Colon cancer screening. Family history of colon polyps.
Colonoscopy - 22
Mild-to-moderate diverticulosis. She was referred for a screening colonoscopy. There is no family history of colon cancer. No evidence of polyps or malignancy.
Colonoscopy - 3
Colonoscopy to evaluate prior history of neoplastic polyps.
Colonoscopy - 4
Colonoscopy - Diarrhea, suspected irritable bowel
Colonoscopy - 5
Colonoscopy due to hematochezia and personal history of colonic polyps.
Colonoscopy - 6
Colonoscopy to screen for colon cancer
Colonoscopy - 7
Patient with history of adenomas and irregular bowel habits.
Colonoscopy - 8
Patient with active flare of Inflammatory Bowel Disease, not responsive to conventional therapy including sulfasalazine, cortisone, local therapy.
Colonoscopy - 9
Patient with history of polyps.
Colonoscopy & Esophagogastroduodenoscopy
Colonoscopy to cecum with snare polypectomy and esophagogastroduodenoscopy with biopsies. Hematochezia, refractory dyspepsia, colonic polyps at 35 cm and 15 cm, diverticulosis coli, and acute and chronic gastritis.
Colonoscopy & Polypectomy - 1
Total colonoscopy and polypectomy
Colonoscopy & Polypectomy - 2
Colonoscopy, conscious sedation, and snare polypectomy.
Colonoscopy & Polypectomy - 3
Total colonoscopy with biopsy and snare polypectomy.
Colonoscopy Template - 1
Common description of colonoscopy
Colonoscopy Template - 2
Common description of colonoscopy
Colonoscopy Template - 3
Common description of colonoscopy
Colonoscopy Template - 4
Common description of colonoscopy
Colonoscopy Template - 5
Common description of colonoscopy
Colonoscopy with Biopsy
A woman referred for colonoscopy secondary to heme-positive stools. Procedure done to rule out generalized diverticular change, colitis, and neoplasia.
Colonoscopy with Biopsy - 1
The patient with a recent change in bowel function and hematochezia.
Colonoscopy with Biopsy - 2
Small internal hemorrhoids and Ileal colonic anastomosis.
Colonoscopy with Biopsy - 3
Colonoscopy with multiple biopsies, including terminal ileum, cecum, hepatic flexure, and sigmoid colon.
Colonoscopy with Biopsy - 4
Colonoscopy with random biopsies and culture.
Colonoscopy With Photos
Colonoscopy with photos. The patient is an 85-year-old female who was admitted to the hospital with a markedly decreased hemoglobin and blood loss anemia. She underwent an EGD and attempted colonoscopy; however, due to a very poor prep, only a flexible sigmoidoscopy was performed at that time. A coloscopy is now being performed for completion.
Colostomy Failure
Patient in ER due to colostomy failure - bowel obstruction.
Constipation - 1
Patient complains of constipation. Has not had BM for two days.
Consult - Laparoscopic Cholecystectomy
Patient with mid-epigastric abdominal pain. Sonogram revealed gallstones.
Consult - Multiple Colon Polyps
A 50-year-old female whose 51-year-old sister has a history of multiple colon polyps, which may slightly increase her risk for colon cancer in the future.
Consult - Rectal Bleeding
Patient with family history of colon cancer and has rectal bleeding on a weekly basis and also heartburn once every 1 or 2 weeks.
Consult - Screening Colonoscopy
Patient comes for discussion of a screening colonoscopy.
Consult for Colostomy Reversal
Patient presents for a colostomy reversal as well as repair of an incisional hernia.
CT Abdomen & Pelvis
CT Abdomen & Pelvis W&WO Contrast
CT Abdomen & Pelvis - 1
CT Abdomen and Pelvis with contrast
CT Abdomen & Pelvis - 10
Evaluate for retroperitoneal hematoma, the patient has been following, is currently on Coumadin. CT abdomen without contrast and CT pelvis without contrast.
CT Abdomen & Pelvis - 11
Abnormal liver enzymes and diarrhea. CT pelvis with contrast and ct abdomen with and without contrast.
CT Abdomen & Pelvis - 2
CT scan of the abdomen and pelvis without and with intravenous contrast.
CT Abdomen & Pelvis - 3
CT of the abdomen and pelvis without contrast.
CT Abdomen & Pelvis - 4
CT abdomen and pelvis without contrast, stone protocol, reconstruction.
CT Abdomen & Pelvis - 5
CT abdomen without contrast and pelvis without contrast, reconstruction.
CT Abdomen & Pelvis - 6
Right-sided abdominal pain with nausea and fever. CT abdomen with contrast and CT pelvis with contrast. Axial CT images of the abdomen and pelvis were obtained utilizing 100 mL of Isovue-300.
CT Abdomen & Pelvis - 7
Lower quadrant pain with nausea, vomiting, and diarrhea. CT abdomen without contrast and CT pelvis without contrast. Noncontrast axial CT images of the abdomen and pelvis are obtained.
CT Abdomen & Pelvis - 8
Generalized abdominal pain, nausea, diarrhea, and recent colonic resection. CT abdomen with and without contrast and CT pelvis with contrast. Axial CT images of the abdomen were obtained without contrast. Axial CT images of the abdomen and pelvis were then obtained utilizing 100 mL of Isovue-300.
CT Abdomen & Pelvis - 9
Generalized abdominal pain with swelling at the site of the ileostomy. CT abdomen with contrast and CT pelvis with contrast. Axial CT images of the abdomen and pelvis were obtained utilizing 100 mL of Isovue-300.
CT Abdomen & Pelvis - OB-GYN
Abdominal pain. CT examination of the abdomen and pelvis with intravenous contrast.
CT Scan of Abdomen & Pelvis with Contrast
CT scan of the abdomen and pelvis with contrast to evaluate abdominal pan.
Deglutition Study - Modified Barium swallow
Modified Barium swallow (Deglutition Study) for Dysphagia with possible aspiration.
Discharge Summary - 10
Patient with a history of a Nissen fundoplication performed six years ago for gastric reflux.
Discharge Summary - Cholelithiasis
Patient with complaint of symptomatic cholelithiasis.
Diverticulectomy & Laparotomy
Diagnostic laparotomy, exploratory laparotomy, Meckel's diverticulectomy, open incidental appendectomy, and peritoneal toilet.
Dysphagia & Hematemesis
Dysphagia and hematemesis while vomiting. Diffuse esophageal dilatation/hematemesis
EGD - 1
Problems with dysphagia to solids and had food impacted in the lower esophagus. Upper endoscopy to evaluate the esophagus.
EGD - 2
Esophagogastroduodenoscopy, patient with dysphagia.
EGD - Colonoscopy - Polypectomy
Esophagogastroduodenoscopy and colonoscopy with polypectomy
EGD & Colonoscopy
EGD and colonoscopy. Blood loss anemia, normal colon with no evidence of bleeding, hiatal hernia, fundal gastritis with polyps, and antral mass.
EGD & PEG Tube Placement
EGD with PEG tube placement using Russell technique. Protein-calorie malnutrition, intractable nausea, vomiting, and dysphagia, and enterogastritis.
EGD Template - 1
Common description of EGD.
EGD Template - 2
Common description of EGD.
EGD Template - 3
Common description of EGD.
EGD Template - 4
Common description of EGD
EGD with Biopsy - 1
Patient admitted because of recurrent nausea and vomiting, with displacement of the GEJ feeding tube.
EGD with Biopsy - 2
Esophagogastroduodenoscopy with biopsy. Patient has had biliary colic-type symptoms for the past 3-1/2 weeks, characterized by severe pain, and brought on by eating greasy foods.
EGD with Dilation
EGD with dilation for dysphagia.
EGD With Photos & Biopsies.
EGD with photos and biopsies. This is a 75-year-old female who presents with difficulty swallowing, occasional choking, and odynophagia. She has a previous history of hiatal hernia. She was on Prevacid currently.
Endoscopy
Upper gastrointestinal endoscopy.
Endoscopy - 1
Upper endoscopy, patient with dysphagia.
Endoscopy - 2
Melena and solitary erosion over a fold at the GE junction, gastric side.
Endoscopy - 3
Patient with dysphagia.
Endoscopy - 4
Intermittent rectal bleeding with abdominal pain.
Endoscopy Template
Normal upper GI endoscopy.
Endoscopy With Biopsy
Upper endoscopy with biopsy. The patient admitted for coffee-ground emesis, which has been going on for the past several days. An endoscopy is being done to evaluate for source of upper GI bleeding.
Endovascular Abdominal Aortic Aneurysm Repair
The patient was brought to the OR with the known 4 cm abdominal aortic aneurysm + 2.5 cm right common iliac artery aneurysm.
Epigastric Herniorrhaphy
Epigastric herniorrhaphy. Epigastric hernia.
ER Report - Stomach Pain
Patient presents to the emergency room with complaints of mid-epigastric and right upper quadrant abdominal pain for the last 14 days.
ERCP
Endoscopic retrograde cholangiopancreatography (ERCP) with brush cytology and biopsy.
Esophagogastrectomy, Jejunostomy, & Chest Tubes
Ivor-Lewis esophagogastrectomy, feeding jejunostomy, placement of two right-sided 28 French chest tubes, and right thoracotomy.
Esophagogastroduodenoscopy
Esophagogastroduodenoscopy with biopsy and snare polypectomy - Iron-deficiency anemia
Esophagogastroduodenoscopy - 1
Esophagogastroduodenoscopy with biopsy, a 1-year-10-month-old with a history of dysphagia to solids.
Esophagogastroduodenoscopy - 10
Esophagogastroduodenoscopy with antral biopsies for H. pylori x2 with biopsy forceps. Nausea and vomiting and upper abdominal pain.
Esophagogastroduodenoscopy - 11
Esophagogastroduodenoscopy with bile aspirate. Recurrent right upper quadrant pain with failure of antacid medical therapy. Normal esophageal gastroduodenoscopy.
Esophagogastroduodenoscopy - 12
Esophagogastroduodenoscopy, photography, and biopsy. Gastroesophageal reflux disease, hiatal hernia, and enterogastritis.
Esophagogastroduodenoscopy - 13
Esophagogastroduodenoscopy performed in the emergency department.
Esophagogastroduodenoscopy - 2
Esophagogastroduodenoscopy with biopsy.
Esophagogastroduodenoscopy - 3
Esophagogastroduodenoscopy and colonoscopy with biopsy and polypectomy.
Esophagogastroduodenoscopy - 4
Esophagogastroduodenoscopy with biopsy and colonoscopy with biopsy.
Esophagogastroduodenoscopy - 5
Esophagogastroduodenoscopy. The Olympus video panendoscope was advanced under direct vision into the esophagus. The esophagus was normal in appearance and configuration. The gastroesophageal junction was normal.
Esophagogastroduodenoscopy - 6
Esophagogastroduodenoscopy. The Olympus video gastroscope was then introduced into the upper esophagus and passed by direct vision to the descending duodenum.
Esophagogastroduodenoscopy - 7
Positive peptic ulcer disease. Gastritis. Esophagogastroduodenoscopy with photography and biopsy. The patient had a history of peptic ulcer disease, epigastric abdominal pain x2 months, being evaluated at this time for ulcer disease.
Esophagogastroduodenoscopy - 8
Chronic abdominal pain and heme positive stool, antral gastritis, and duodenal polyp. Esophagogastroduodenoscopy with photos and antral biopsy.
Esophagogastroduodenoscopy - 9
Esophagogastroduodenoscopy with biopsy of one of the polyps and percutaneous endoscopic gastrostomy tube placement. Malnutrition and dysphagia with two antral polyps and large hiatal hernia.
Esophagogastroduodenoscopy & Gastrostomy Tube Insertion
Esophagogastroduodenoscopy with photo. Insertion of a percutaneous endoscopic gastrostomy tube. Neuromuscular dysphagia. Protein-calorie malnutrition.
Esophagogastroduodenoscopy with Biopsies
Esophagogastroduodenoscopy with biopsies. Gastroesophageal reflux disease, chronic dyspepsia, alkaline reflux gastritis, gastroparesis, probable Billroth II anastomosis, and status post Whipple's pancreaticoduodenectomy.
Esophagogastroduodenoscopy with Biopsies - 1
Esophagogastroduodenoscopy with gastric biopsies. Antral erythema; 2 cm polypoid pyloric channel tissue, questionable inflammatory polyp which was biopsied; duodenal erythema and erosion.
Esophagogastroduodenoscopy with Biopsies -2
Esophagogastroduodenoscopy with pseudo and esophageal biopsy. Hiatal hernia and reflux esophagitis. The patient is a 52-year-old female morbidly obese black female who has a long history of reflux and GERD type symptoms including complications such as hoarseness and chronic cough.
Esophagoscopy & Foreign Body Removal
Esophageal foreign body, US penny. Esophagoscopy with foreign body removal. The patient had a penny lodged in the proximal esophagus in the typical location.
Esophagoscopy & Foreign Body Removal - 1
Esophagoscopy with removal of foreign body. Esophageal foreign body, no associated comorbidities are noted.
Exploratory Laparotomy
Leaking anastomosis from esophagogastrectomy. Exploratory laparotomy and drainage of intra-abdominal abscesses with control of leakage.
Exploratory Laparotomy - 1
Exploratory laparotomy, lysis of adhesions and removal, reversal of Hartmann's colostomy, flexible sigmoidoscopy, and cystoscopy with left ureteral stent.
Exploratory Laparotomy & Colon Resection
Exploratory laparotomy, low anterior colon resection, flexible colonoscopy, and transverse loop colostomy and JP placement. Colovesical fistula and intraperitoneal abscess.
Exploratory Laparotomy & Hernia Repair
Exploratory laparotomy, release of small bowel obstruction, and repair of periumbilical hernia. Acute small bowel obstruction and incarcerated umbilical Hernia.
Flex Sig
Flexible Sigmoidoscopy.
Flex Sig - 1
Flexible sigmoidoscopy due to rectal bleeding.
Flex Sig - 2
Flexible sigmoidoscopy. The Olympus video colonoscope then introduced into the rectum and passed by directed vision to the distal descending colon.
Flex Sig - 3
Flexible sigmoidoscopy. Sigmoid and left colon diverticulosis; otherwise, normal flexible sigmoidoscopy to the proximal descending colon.
Foul-Smelling Urine
Foul-smelling urine and stomach pain after meals.
Fundoplication & Gastrostomy Followup
Followup of laparoscopic fundoplication and gastrostomy. Laparoscopic fundoplication and gastrostomy was done because of the need for enteral feeding access.
Gagging - 3-year-old
Pediatric Gastroenterology - History of gagging.
Gastroenteritis - Discharge Summary
Acute gastroenteritis, resolved. Gastrointestinal bleed and chronic inflammation of the mesentery of unknown etiology.
Gastroenterology - Letter
Female with intermittent rectal bleeding, not associated with any weight loss. The patient is chronically constipated.
Gastrointestinal Bleed - Discharge Summary
Gastrointestinal bleed, source undetermined, but possibly due to internal hemorrhoids. Poor prep with friable internal hemorrhoids, but no gross lesions, no source of bleed.
Gastrointestinal Bleed - ER Visit
Gastrointestinal Bleed. An 81-year-old presented to the emergency room after having multiple black tarry stools and a weak spell. She woke yesterday morning had a very dark and smelly bowel movement.
Gastroscopy
Esophagitis, minor stricture at the gastroesophageal junction, hiatal hernia. Otherwise normal upper endoscopy to the transverse duodenum.
Gastroscopy - 1
Dysphagia, possible stricture. Retained gastric contents forming a partial bezoar, suggestive of gastroparesis.
Gastroscopy - 2
Gastroscopy. Dysphagia and globus. No evidence of inflammation or narrowing to explain her symptoms.
Gastroscopy - 3
Gastroscopy. A short-segment Barrett esophagus, hiatal hernia, and incidental fundic gland polyps in the gastric body; otherwise, normal upper endoscopy to the transverse duodenum.
Gastrostomy
Gastrostomy, a 6-week-old with feeding disorder and Down syndrome.
GI Bleed - Discharge Summary
GI bleed. Upper gastrointestinal bleed. CBC revealed microcytic anemia.
GI Consultation - 1
GI Consultation due to rectal bleeding, positive celiac sprue panel
GI Consultation - 2
GI Consultation for chronic abdominal pain, nausea, vomiting, abnormal liver function tests.
GI Consultation - 3
GI Consultation for Chrohn's disease.
GI Consultation - 4
Nausea and abdominal pain after eating - Gall bladder disease - Laparoscopic cholecystectomy scheduled.
Hemicolectomy
Exploratory laparotomy, lysis of adhesions, and right hemicolectomy. Right colon cancer, ascites, and adhesions.
Hepatic Encephalopathy
A male with known alcohol cirrhosis who presented to the emergency room after an accidental fall in the bathroom.
Hepatobiliary Scan
Right upper quadrant pain. Nuclear medicine hepatobiliary scan. Radiopharmaceutical 6.9 mCi of Technetium-99m Choletec.
Ischemic Cecum - Consult
Pneumatosis coli in the cecum. Possible ischemic cecum with possible metastatic disease, bilateral hydronephrosis on atrial fibrillation, aspiration pneumonia, chronic alcohol abuse, acute renal failure, COPD, anemia with gastric ulcer.
Ischial Ulcer Debridement
Debridement left ischial ulcer.
Juxtarenal Abdominal Aortic Aneurysm Repair
Repair of juxtarenal abdominal aortic aneurysm with 14 mm Hemashield tube graft.
Lap Chole - Discharge Summary
Laparoscopic cholecystectomy. Acute cholecystitis, status post laparoscopic cholecystectomy, end-stage renal disease on hemodialysis, hyperlipidemia, hypertension, congestive heart failure, skin lymphoma 5 years ago, and hypothyroidism.
Laparoscopic Appendectomy
Laparoscopic appendectomy. Acute appendicitis.
Laparoscopic Appendectomy - 1
Ruptured appendicitis.
Laparoscopic Appendectomy - 2
Appendicitis. Laparoscopic appendectomy. Infraumbilical incision was performed and taken down to the fascia. The fascia was incised. The peritoneal cavity was carefully entered. Two other ports were placed in the right and left lower quadrants.
Laparoscopic Appendectomy - 3
Appendicitis. Laparoscopic appendectomy. CO2 insufflation was done to a maximum pressure of 15 mmHg and a 12-mm VersaStep port was placed through his umbilicus.
Laparoscopic Appendectomy - 4
Acute appendicitis with perforation. Laparoscopic appendectomy. A CT scan of abdomen showed evidence of appendicitis with perforation.
Laparoscopic Appendectomy - 5
Laparoscopic appendectomy. The patient is a 42-year-old female who presented with right lower quadrant pain. She was evaluated and found to have a CT evidence of appendicitis.
Laparoscopic Cholecystectomy
Standard Laparoscopic Cholecystectomy Operative Note.
Laparoscopic Cholecystectomy - 1
Laparoscopic cholecystectomy.
Laparoscopic Cholecystectomy - 10
Laparoscopic cholecystectomy. Biliary colic and biliary dyskinesia. The patient had a workup for her gallbladder, which showed evidence of biliary dyskinesia.
Laparoscopic Cholecystectomy - 2
Laparoscopic cholecystectomy due to chronic cholecystitis and cholelithiasis.
Laparoscopic Cholecystectomy - 3
Chronic cholecystitis without cholelithiasis.
Laparoscopic Cholecystectomy - 4
Acute cholecystitis. Laparoscopic cholecystectomy. The abdominal area was prepped and draped in the usual sterile fashion. A small skin incision was made below the umbilicus. It was carried down in the transverse direction on the side of her old incision. It was carried down to the fascia.
Laparoscopic Cholecystectomy - 5
Biliary colic. Laparoscopic cholecystectomy. Laparoscopic examination showed no injury from entry. Marcaine was then injected just subxiphoid, and a 5-mm port was placed under direct visualization for the laparoscope.
Laparoscopic Cholecystectomy - 6
Cholelithiasis; possible choledocholithiasis. Laparoscopic cholecystectomy and intraoperative cholangiogram. A small incision was made in the umbilicus, and a Veress needle was introduced into the abdomen. CO2 insufflation was done to a maximum pressure of 15 mmHg, and a 12-mm VersaStep port was placed into the umbilicus.
Laparoscopic Cholecystectomy - 7
Cholecystitis and cholelithiasis. Laparoscopic cholecystectomy and intraoperative cholangiogram. The patient received 1 gm of IV Ancef intravenously piggyback. The abdomen was prepared and draped in routine sterile fashion.
Laparoscopic Cholecystectomy - 8
Chronic cholecystitis. Laparoscopic cholecystectomy. Patient with increasingly severe more frequent right upper quadrant abdominal pain, more after meals, had a positive ultrasound for significant biliary sludge.
Laparoscopic Cholecystectomy - 9
Laparoscopic cholecystectomy. A 2 cm infraumbilical midline incision was made. The fascia was then cleared of subcutaneous tissue using a tonsil clamp.
Laparoscopic Cholecystectomy & Appendectomy
Symptomatic cholelithiasis. Laparoscopic cholecystectomy and appendectomy (CPT 47563, 44970). The patient requested appendectomy because of the concern of future diagnostic dilemma with pain crisis. Laparoscopic cholecystectomy and appendectomy were recommended to her.
Laparoscopic Cholecystectomy & Cholangiogram
Laparoscopic cholecystectomy with cholangiogram. Acute gangrenous cholecystitis with cholelithiasis. The patient had essentially a dead gallbladder with stones and positive wide bile/pus coming from the gallbladder.
Laparoscopic Cholecystectomy & Cholangiogram - 1
Laparoscopic cholecystectomy with attempted intraoperative cholangiogram. A 2 cm infraumbilical midline incision was made. The fascia was then cleared of subcutaneous tissue using a tonsil clamp.
Laparoscopic Cholecystectomy & Liver Cyst Excision
Chronic cholecystitis, cholelithiasis, and liver cyst. Laparoscopic cholecystectomy and excision of liver cyst. Exploration of the abdomen revealed multiple adhesions of omentum overlying the posterior aspect of the gallbladder.
Laparoscopic Gastric Bypass
Morbid obesity. Laparoscopic antecolic antegastric Roux-en-Y gastric bypass with EEA anastomosis. This is a 30-year-old female, who has been overweight for many years. She has tried many different diets, but is unsuccessful.
Laparoscopic Gastric Bypass - 1
Morbid obesity. Laparoscopic Roux-en-Y gastric bypass, antecolic, antegastric with 25-mm EEA anastamosis, esophagogastroduodenoscopy.
Laparoscopy & Laparoscopic Appendectomy
Diagnostic laparoscopy and laparoscopic appendectomy. Right lower quadrant abdominal pain, rule out acute appendicitis.
Laparoscopy & Sigmoidoscopy
Diagnostic laparoscopy and rigid sigmoidoscopy. Acute pain, fever postoperatively, hemostatic uterine perforation, no bowel or vascular trauma.
Laparoscopy, Laparotomy, & Cholecystectomy
Laparoscopy, laparotomy, cholecystectomy with operative cholangiogram, choledocholithotomy with operative choledochoscopy and T-tube drainage of the common bile duct.
Liver Biopsy
Percutaneous liver biopsy. With the patient lying in the supine position and the right hand underneath the head, an area of maximal dullness was identified in the mid-axillary location by percussion.
Lower Quadrant Pain
Abdominal pain right lower quadrant, radiating around her side to her right flank. Etiology is unclear.
Melena - ICU Followup
Reason for ICU followup today is acute anemia secondary to upper GI bleeding with melena with dropping hemoglobin from 11 to 8, status post transfusion of 2 units PRBCs with EGD performed earlier today by Dr. X of Gastroenterology confirming diagnosis of ulcerative esophagitis, also for continuing chronic obstructive pulmonary disease exacerbation with productive cough, infection and shortness of breath.
Multiple Medical Problems - Discharge Summary
Seizure, hypoglycemia, anemia, dyspnea, edema. colon cancer status post right hemicolectomy, hospital-acquired pneumonia, and congestive heart failure.
Nissen Fundoplication
Nissen fundoplication. A 2 cm midline incision was made at the junction of the upper two-thirds and lower one-third between the umbilicus and the xiphoid process.
Open Cholecystectomy
Acute acalculous cholecystitis. Open cholecystectomy. The patient's gallbladder had some patchy and necrosis areas. There were particular changes on the serosal surface as well as on the mucosal surface with multiple clots within the gallbladder.
Pancreatic Mass - Discharge Summary
The patient has had abdominal pain associated with a 30-pound weight loss and then developed jaundice. He had epigastric pain and was admitted to the hospital. A thin-slice CT scan was performed, which revealed a pancreatic mass with involved lymph nodes and ring enhancing lesions consistent with liver metastases.
Paracentesis
Paracentesis. A large abdominal mass, which was cystic in nature and the radiologist inserted a pigtail catheter in the emergency room.
Paracentesis - Ultrasound-Guided
Ultrasound-Guided Paracentesis for Ascites
PEG Tube
Percutaneous endoscopic gastrostomy tube. Protein-calorie malnutrition. The patient was unable to sustain enough caloric intake and had markedly decreased albumin stores. After discussion with the patient and the son, they agreed to place a PEG tube for nutritional supplementation.
Postop Transanal Excision
Bleeding after transanal excision five days ago. Exam under anesthesia with control of bleeding via cautery. The patient is a 42-year-old gentleman who is five days out from transanal excision of a benign anterior base lesion. He presents today with diarrhea and bleeding.
Proctitis & Proctocolitis
Patient presents to the emergency department (ED) with rectal bleeding and pain on defecation.
Progress Note - Liver Cirrhosis
Patient seen initially with epigastric and right upper quadrant abdominal pain, nausea, dizziness, and bloating.
Rectal Bleeding - 1-year-old
Pediatric Gastroenterology - Rectal Bleeding Consult.
Rectal Bleeding - Consult
A 68-year-old male with history of bilateral hernia repair, who presents with 3 weeks of diarrhea and 1 week of rectal bleeding. He states that he had some stomach discomfort in the last 4 weeks.
Sigmoidoscopy - 1
Sigmoidoscopy performed for evaluation of anemia, gastrointestinal Bleeding.
Small Bowel Obstruction
History of abdominal pain, obstipation, and distention with nausea and vomiting - paralytic ileus and mechanical obstruction.
SOAP - Cholecystitis
She is a 79-year-old female who came in with acute cholecystitis and underwent attempted laparoscopic cholecystectomy 8 days ago. The patient has required conversion to an open procedure due to difficult anatomy. Her postoperative course has been lengthened due to a prolonged ileus, which resolved with tetracycline and Reglan. The patient is starting to improve, gain more strength. She is tolerating her regular diet.
Stamm Gastrostomy Tube Placement
Open Stamm gastrotomy tube, lysis of adhesions, and closure of incidental colotomy
Status Post Liver Transplant
A 10-year-old with a history of biliary atresia and status post orthotopic liver transplantation.
Surgical Closure of Gastrostomy
Closure of gastrostomy placed due to feeding difficulties.
Thoracotomy & Esophageal Exploration
Left thoracotomy with drainage of pleural fluid collection, esophageal exploration and repair of esophageal perforation, diagnostic laparoscopy and gastrostomy, and radiographic gastrostomy tube study with gastric contrast, interpretation.
Ttriple-Lumen Central Line
Insertion of a triple-lumen central line through the right subclavian vein by the percutaneous technique. This lady has a bowel obstruction. She was being fed through a central line, which as per the patient was just put yesterday and this slipped out.
Ultrasound - Abdomen
Ultrasound abdomen, complete
Ultrasound - Abdomen - 1
Ultrasound Abdomen - elevated liver function tests.
Umbilical Hernia Repair
Umbilical hernia repair template. The umbilical hernia carefully reduced back into the cavity, and the fascia was closed with interrupted vertical mattress sutures to approximate the fascia.
Umbilical Hernia Repair - 1
Umbilical hernia repair. A standard curvilinear umbilical incision was made, and dissection was carried down to the hernia sac using a combination of Metzenbaum scissors and Bovie electrocautery.
Upper Endoscopy
Upper endoscopy with removal of food impaction.
Upper Endoscopy - Foreign Body Removal
Upper endoscopy with foreign body removal (Penny in proximal esophagus).
Viral Gastroenteritis
Viral gastroenteritis. Patient complaining of the onset of nausea and vomiting after she drank lots of red wine. She denies any sore throat or cough. She states no one else at home has been ill.
Wound Check - Status Post APR
This is a pleasant 50-year-old female who has undergone an APR secondary to refractory ulcerative colitis. Overall, her quality of life has significantly improved since she had her APR. She is functioning well with her ileostomy.