Case Study: March 2015: Prashant Krishnan, MD

Facility: Front Range Endoscopy (Colorado Springs, CO) Physician: Prashant Krishnan, MD

Date: March, 2015

Case Study:

In March 2015, a 40-year-old female presented with dysphagia for an EGD. The patient reported difficulty when swallowing solids. She explained that she felt as though something was stuck in the upper chest area. She also complained of the sensation of regurgitation in her throat resulting in coughing.

Procedure Information/Data

During the procedure, after traversing the upper esophageal sphincter, the upper esophagus could be visualized. In Figure 1, the center screen revealed a small opening, likely a diverticulum. This diverticulum appears to be shallow. The size of the diverticulum cannot be appreciated in this picture.

Fuse Case Study Krishnan EGD Diverticulum

Figure 1

Upon moving the scope further down into the esophagus, the left camera can be used to better visualize the diverticulum. As shown in Figure 2, the diverticulum in the upper esophagus is clearly visible. Furthermore, the size of the diverticulum can be appreciated as can the presence of food within the diverticulum.

Fuse Case Study Krishnan Diverticulum

Figure 2

In Video 1 below, the esophageal lumen is visible in the center camera. The upper esophageal diverticulum is visible in the left camera. The size of the diverticulum can be easily appreciated in the left camera and food within the diverticulum is visible. This likely explains her dysphagia.

Video 1 

Conclusions

The center camera on the Fuse gastroscope allowed me to see a diverticulum in the upper esophagus, which appears shallow. I could not fully appreciate the size of the diverticulum in the center camera. However, with the Fuse scope, I was able to use the left camera to clearly see and appreciate the size of the diverticulum and see the food within the diverticulum. The video shows this too. There was no luminal narrowing. Biopsies of the esophagus were negative for eosinophilic esophagitis. This diverticulum seen clearly in the left camera in the upper esophagus is the likely etiology of her dysphagia. I feel using the Fuse scope with the left camera improved the care I provided to this patient, allowing me to provide a more definite diagnosis.

 
DOWNLOAD CASE REPORT