| Most of you coming to this Web Site know that I have been diagnosed with Cancer, and by now, you know that my Faith is my Light. Goto "The Good News" page to read testimonies to God's mercy and power. |
Mark Birch
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| Procedure Date: 02/08/2010 Scope(s) Used Detail: GIF-HI 80-2806447 Introduction: A 54 year old male patient presents for Upper Endoscopic [ULTRASOUND]. Indications: Mr. Birch is a 54 year old male with a history of pancreatic cancer with metastasis who presents for evaluation of a nodule seen near the pancreatic head seen on recent surveilance PET scan. Consent: The procedure, indications, potential complications (bleeding, perforation, infection, adverse medication reaction), and alternatives to the procedure were discussed with opportunity for questions. Informed consent was obtained. Preparation: EKG, pulse, pulse oximetry, and blood pressure were monitored throughout the procedure. Medications: TIVA Procedure: The endoscope was passed with ease through the mouth under direct visualization to the duodenum The scope was withdrawn and the mucosa was carefully examined. The views were good. The patient's toleration of the procedure was good. Findings: EGD Exam: The upper endoscope was introduced into the esopahgus. The proximal and mid esophagus was normal in appearance. At the GEJ, mild erythema was noted consistent with mild esophagitis. The GEJ was noted at 45cms. The stomach was carefully examined including retroflexed views of the angularis, cardia, and fundus. No abnormalities were noted. The first and the second portion of the duodenum appeared normal with no mucosal abnormality. EUS Exam: Olympus linear echoendoscope was used for this procedure. The pancreas was carefully examined from the uncinate process to the tail where the spleen was seen. The pancreatic duct was not dilated. The pancreatic parenchyma was normal in the pancreas away from the biliary stent with no calcifications or lobulations. There was no evidence of a mass or enlarged lymph node in the pancreas or adjacent to the pancreas. No peri-pancreatic, peri-portal, celiac, or gastriclymph nodes were found. Hypoechoic changes were seen in the area of the stent consistent with inflammation. No distinct mass identified around stent, in pancreas or in peri-pancreatic space. Other Events: There were no complications. Estimated Blood Loss: None. Summary: 1) No lymph node/mass lesion seen in the pancreas or adjacent to the pancreas. Suspect nodule seen on imaging is the same echogenicity as pancreatic parenchyma and thus not visualized 2) Mild esophagitis Recommendations: 1) Consider CT guided biopsy 2) PPI 3) Follow up with referring physician |