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VideoGIE Image Quiz

  1. Things are coming apart

    A 40-year-old man with rectal adenocarcinoma is treated with neoadjuvant chemoradiation followed by low anterior resection with diverting loop ileostomy. On postoperative day 8 he develops fever and rectal pain with discharge. CT scan of the abdomen and pelvis is shown in the image. Given the low rectal location of the anastomosis, endoluminal vacuum therapy is performed with good clinical response. Which of the following statements about anastomotic leaks is correct?
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  2. When will I see you again?

    A 72-year-old man is found to have a 15-mm flat elevated polyp encircling the appendiceal os and extending into the appendix. The polyp is removed by endoscopic transcecal appendectomy with laparoscopic assistance. Histologic diagnosis is a sessile-serrated lesion. If this lesion was removed by EMR during routine colonoscopy, what is the appropriate interval for follow-up?
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  3. A NICE Q & A

    An 89-year-old woman undergoes surgery for sigmoid adenocarcinoma 1 year prior to presentation. She presents for surveillance colonoscopy and is found to have a large rectal polyp. It is removed endoscopically using underwater EMR technique. What is the most likely NICE classification of this lesion?
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  4. Dysphagia diagnosis

    A 76-year-old man presents with dysphagia. An upper endoscopy is performed and reveals the lesion pictured. A CT scan of the chest demonstrates the lesion is 2.5 cm and located in the mid esophagus. It was ultimately resected using Holmium laser enucleation with tunnel technique. The most likely histologic diagnosis of this lesion is:
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  5. A prickly puzzle

    Which endoscopic tool might be useful in this situation?
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  6. Outlet obstruction

    A 66-year-old man was diagnosed with gastric lymphoma with pyloric involvement (blue arrow) resulting in gastric outlet obstruction. After treatment of his gastric lymphoma, complete occlusion of the pylorus remained despite complete healing of the ulcer. Which procedure attempts to restore the normal gastric anatomy?
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  7. Symptomatic gastric lesion

    A 77-year-old woman presented with symptomatic anemia. EGD revealed the pictured lesion. Which of the following statements is true regarding the finding?
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  8. Symptomatic finding

    A 74-year-old man presented with nausea and vomiting. Representative images of the CT (a and b), MRI (c), and upper GI series (d) are shown. What etiology is responsible for this patient’s symptoms?
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  9. Lead the way to the lesion

    A 90-year-old man presents with acute onset abdominal pain and nausea. He has abdominal distention, and a CT scan is obtained. Colonoscopy is performed on day 1 for decompression with symptomatic relief. Because the patient is a poor surgical candidate, on day 4 the lesion in the ileum is partially resected as shown here to prevent recurrent episodes. Which of the following is the most likely diagnosis of this lesion?
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  10. When blood is thicker than water, use gel

    A 76-year-old woman with a history of chronic kidney disease and heart failure on warfarin presents with a lower GI bleed. The source of bleeding could not be identified on previous colonoscopy. Despite copious blood and clot again filling the lumen of the colon, the colonoscope was successfully advanced to the cecum using the gel immersion technique. This actively oozing lesion is identified. Which of the following is the most likely diagnosis of this lesion?
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