Present an Intestinal Failure Case Study to LIFT-ECHO

If you have a challenging case you’d like to present or are interested in learning more about it, sign up below and a member of our team will reach out to you! Please know that completing this survey does not commit you to presenting. The purpose of this survey is simply to gauge interest and availability.

Each 60-minute session dedicates 35 minutes to discuss a real-life case study submitted by one of our spokes. Appropriate cases may be broadly in the areas of intestinal failure, short bowel syndrome, TPN-dependency, etc. However, if you are in doubt about a particular case, do feel free to reach out to Dr. Kishore Iyer directly or submit a query through our website. Please make sure to provide your contact information so we can get back to you.

Note: Our teleECHO clinics are fully HIPAA-compliant. When submitting or presenting a case, please take care to not reveal any PHI. You may review the HIPAA privacy policy here.

Clinic Template

Presenting Clinician *

Presenting Clinician's E-mail *

Phone Number

Primary MD

Primary MD E-mail

Phone Number

Patient Age

HPI

PMH

PSH

Current Intestinal Anatomy (Please specify if small bowel is in continuity with colon, and percentage of colon)

TPN (If yes, please specify volume and how many hours/day)

Enteral (If yes, please specify formula and how many hours/day)

Current Vascular Access (Type, i.e. Hickman vs. PICC vs. PORT and location)

Current Enteral Access (i.e. G tube/J tube)

Parenteral Nutrition Complications (i.e. loss of vascular access, line infections, liver dysfunction)

Pertinent Physical Exam Findings (i.e. mark tubes, stomas, wounds, hernia, fistulae, etc.)

TPN Prescription

Present an Intestinal Failure Case Study to LIFT-ECHO

Clinic Template

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