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Interactive Case studies - Learning Center

The interactive learning section shows different and interesting cases from upper and lower GI. After clicking onto a specific case study a short introduction to this case study is given. Afterwards endoscopic, confocal and histological pictures as well as short video sequences of different disease patterns from upper to lower GI are shown.

Take the unique opportunity to make your own diagnosis afterwards press the "show description/hide description" link to display precisely placed arrows that include explanations and comments of leading experts in the field of endomicroscopy.

If you are already using endomicroscopy you may even publish your own cases. After registration and login to the user-friendly personal area you will be able to upload your own case study including comments on different examination pictures and videos. By publishing your own case studies you may show your scientific ambition and you will furthermore profit by the feedback of the visitors of the endomicroscopy learning centre.

Signet-ring cell carcinoma

Ralf Kiesslich, Prof. Dr.: Nov 24, 2009

42 year old female patient reported about indigestion and loss of appetite, especially for meat.
Former endoscopy revealed gastric cancer in a single random biopsy. Subsequent examinations including CT scan and endosonography as well as repeated gastroscopy with multiple biopsies could not confirm the presence of cancer.
Genetic testing prooved that the biopsy with the malgignant content was from the patient.
Endomicroscopy was performed to identify malignant changes of the mucosa.

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Barrett Esophagus

Ralf Kiesslich, Prof. Dr.: Jul 24, 2009

56 year old male patient with long standing reflux symptoms with predominant heartburn.

Patient was treated with intermittent PPI therapy and was scheduled for upper endoscopy 12 months ago which revealed long segment Barrett’s esophagus.

Patient was currently re-scheduled for endomicroscopy evaluating the presence of Barrett’s epithelium and associated dysplasia.

Endomicroscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent.

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Barrett's associated cancer

Ralf Kiesslich, Prof. Dr.: Aug 05, 2009

61 year old male patient with increased dysphagia was presented for endoscopic evaluation. The Patient suffered from reflux since decades and weight loss occurred during the last six months.

Thoracic and epigastric pain was treated with analgesic (OTC). Upper Endomicroscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent.

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Ulcerative colitis

Ralf Kiesslich, Prof. Dr.: Jul 28, 2009

45 year old female patient with long standing ulcerative colitis was scheduled for surveillance colonoscopy.

Patient has had pancolitis at her last examination. Over the last six months she was in stable clinical remission.

Colonoscopy with endomicroscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent. In addition, chromoendoscopy with methylene blue (~50ml, 0.1%) was performed prior endomicroscopy to unmask circumscribed lesions.

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Colorectal cancer

Ralf Kiesslich, Prof. Dr.: Aug 06, 2009

72 year old female patient was scheduled for colonoscopy due to weight loss and anemia.

Abdominal ultrasound and laboratory workup prior colonoscopy not show any significant abnormalities.

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Colonic Polyps

Ralf Kiesslich, Prof. Dr.: Aug 06, 2009

57 year old female patient was scheduled for screening colonoscopy.

Patient presented in good clinical condition.

Endomicroscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent.

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Depressed early colorectal cancer

Ralf Kiesslich, Prof. Dr.: Aug 06, 2009

76 year old female patient has had abdominal pain and fatigue.
Patient was scheduled for gastroscopy and colonoscopy.

Confocal colonoscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent.

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Colon Polyposis

Ralf Kiesslich, Prof. Dr.: Aug 06, 2009

A 17 year old girl reported about anal bleeding and weight loss.

Family history of colon cancer could not be evaluated because the Afghani patient became orphan right after birth and was adopted by an European family.

Endomicroscopy was performed with fluorescein intravenously (5ml; 10%) as contrast agent.

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Colorectal cancer

Ralf Kiesslich, Prof. Dr.: Aug 30, 2009

62 year old male patient was scheduled for colonoscopy due to diarrhea with peranal bleeding, anemia and weight loss.

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Amyloid disease

Ralf Kiesslich, Prof. Dr.: Nov 24, 2009

49 year old female patient after domino liver transplantation had received an organ of a patient with amyloidosis.
Patient was scheduled for endomicroscopy evaluation 12 months after liver transplantation to clarify whether amyloid deposits might be identifiable.

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