Advanced Imaging of CT and MRI
We use high-field MRI and helical CT scanning to achieve exceptional quality, multi-planar images. MRI and CT vastly improve diagnostic yield, as well as therapeutic and surgical planning, through 3-dimensional visualization of tissue structures and associated pathology. Common applications of this technology include:
- Assessment of the pulmonary parenchyma and nasal passages via CT,
- Assessment of soft tissues such as a brain tumor or liver shunt via MRI.
Balloon Dilation of Esophageal Strictures
This is a procedure which relieves esophageal strictures using a gently expanding balloon. This procedure may be elected to treat the following:
- strictures secondary to trauma of foreign bodies (e.g. chicken bones),
- strictures secondary to anesthesia, and
- strictures secondary to tumors
Biopsy is the collection of a small sample of tissue to help identify the cause of the disease.
- We perform FNA, needle aspirate, needle biopsy, or TruCut biopsy procedures.
- Most biopsies are performed with ultrasound guidance.
- A biopsy may be performed on chest, abdomen or external masses and tumors.
Bladder Stone Removal
Bladder Stone removal may be performed non-invasively using the following techniques:
- Urohydropulsion (using water pressure and a urinary catheter to push out stones)
- Cystoscopy (using a scope to visualize and remove stones). See below to learn more about cystoscopy.
BAL (bronchoalveolar lavage), TTW (transtracheal wash)
BAL (bronchoalveolar lavage), TTW (transtracheal wash) is the collection of a small sample of fluid, cells or tissue to help identify the cause of the disease. With this “lung wash” procedure we …
- sample fluid in the lungs for the purposes of culturing bacteria and other infectious agents, and
- collect cell samples for histopathologic assessment (cytology).
- This procedure is often performed at the same time as bronchoscopy.
Bronchoscopy is a method of non-invasively looking inside the airways by passing a tiny camera on a tube into the lungs via the mouth. We use bronchoscopy to …
- visualize and exam the trachea, mainstem bronchi and upper airways,
- remove foreign material from the airways, e.g. sewing needles, and
- collect cell samples, tissue biopsy and fluid samples for histopathologic assessment and culture.
Bone Marrow sampling
Bone Marrow sampling is the collection of bone marrow to assess platelet, red and white blood cell precursors. This may be performed in one of two ways:
- bone marrow aspirate or
- bone marrow core biopsy.
Colonoscopy is a method of non-invasively looking inside the colon by passing a tiny camera on a tube into the inside of the colon. Via colonoscopy we can …
- visualize and examine the entire colon, including the ascending, transverse and descending colon and rectum,
- remove foreign or impacted material from the colon,
- collect biopsies of the inner mucosal surface of the entire colon, and
- place colonic stents, e.g. for relief of obstructive colonic tumors.
Cystoscopy is a method of non-invasively looking inside the bladder by passing a tiny camera on a tube into the bladder. Via cystoscopy, we are able to …
- visualize and examine the cervix and the inside of the vagina, urethra, urethral papillae and urinary bladder,
- collect cell samples, tissue biopsy and fluid samples for histopathologic assessment and culture, e.g. biopsy tumors,
- remove foreign material, and
- remove small bladder stones.
Endoscopy is a method of non-invasively looking inside the esophagus, stomach and intestines by passing a tiny camera on a tube through the mouth into the upper gastrointestinal tract. With upper endoscopy or gastroduodenoscopy, we can:
- visualize and examine the inner surface of the esophagus, stomach and intestines,
- remove foreign body material from the stomach and esophagus, and
- remove foreign material, and
- collect biopsies of the stomach and intestines.
Feeding Tube Placement
Feeding Tube Placement is the placement of a temporary or permanent tube for a patient who can not or will not eat. We may choose to place any of the following types of tubes:
- Percutaneous endoscopic gastrostomy (PEG) tube
- Gastric feeding tube (non-endoscopic placement)
- Esophageal feeding tube
- Nasal or Naso-esophageal / naso-gastric feeding tube
Intensive Care and Hospitalization
We offer the following advanced care for unstable or critical patients:
- Intravenous fluid and medication therapy
- Transfusion therapy (plasma, red blood cell and platelet blood products, immunoglobulin and chemotherapeutics)
- Intravenous nutrition – total or partial parenteral nutrition
- Blood pressure monitoring
- In-house laboratory
- Digital radiography
- Oxygen therapy – nasal or full oxygen cage
- Removal of excessive fluid build up (thoracocentesis or abdominocentesis)
- 24/7 ICU with licensed nursing staff and doctor in-house at all times
Nasal Fungus treatment
Nasal Fungus treatment is intensive therapy for nasal Aspergillus fungal infection. Details of this procedure are listed below.
- The patient is fully sedated for this procedures, which generally requires several hours.
- First, fungal plaques are manually removed and flushed from the nasal passages.
- Then, an anti-fungal cream or liquid is infused into the nasal passages and sinuses. The nasal passages are occluded to keep the medication in the nose and sinuses.
- The anti-fungal medication is allowed one hour to penetrate into the nasal passages and sinuses.
- Lastly, the nasal passage occlusive materials are removed and the anti-fungal medication allowed to drain.
- The patient is allowed to recover from anesthesia and generally will go home the same day.
Proctoscopy or sigmoidoscopy
Proctoscopy or sigmoidoscopy is a method of non-invasively looking inside the lower colon by passing a tiny camera on a tube into the colon. Using a proctoscope, we can …
- visualize and examine the inside of the distal colon and rectum,
- remove foreign or impacted material from the distal colon, and
- collect biopsies of the inner mucosal surface of the distal colon and rectum.
Rhinoscopy is a method of non-invasively looking inside the nose by passing a tiny camera on a rigid or flexible tube into the nose via the nares. Or, a tiny endoscope may be passed into the nose via the back of the mouth/retropharynx. With rhinoscopy, we can …
- visualize and examine the nasal passages, cranial sinuses and retropharyngeal passages,
- remove nasal foreign material, e.g. impacted feathers, peanuts, toys,
- remove polyps, e.g. using a snare loop, and
- collect biopsies and material for cultures from the nasal passages, tumors or polyps.
Ultrasound is an imaging method used to non-invasively look inside the body using sound waves. The following areas of the body may be surveyed using ultrasound:
- In the abdomen: the stomach, intestines, pancreas, kidneys, adrenal glands, liver, spleen, urinary bladder, lymph nodes, tumors / masses.
- In the chest: lymph nodes, tumors / masses, consolidated lung lobes, contusions, pneumonia.
- Thyroid gland enlargement or tumors.
- Any tumors or masses.
- Muscles / tendons.
Specialty, Advanced and Referral Services
In addition to consultation and advice for acute and chronic diseases, we offer many specialty, advanced and referral services:
- Diabetes mellitus
- Cushing’s disease
- Inflammatory bowel disease
- Protein losing enteropathy and nephropathy
- Immune mediated diseases
- Liver disease
- Kidney disease
- Respiratory diseases, including pneumonia, asthma
- Esophageal and nasal stricture
- and more ….