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Consult Request Guidelines
for Esophageal carcinoma biopsy proven
Esophageal carcinoma biopsy proven
Suggested Pre-Referral Evaluation and Management Guidelines
Preliminary Staging:
Barium swallow
Chest & abdomen CT scan (<2 months old)
Endoscopic ultrasound
PET Scan
Suggested Additional Test/Management Prior to Specialty Visit
Reports:
Barium swallow
Chest & abdomen CT
PET Scan
Pertinent medical history
Prior esophageal operative and EGD reports
Esophagoscopy operative report
Esophagoscopy biopsy pathology report
Pulmonary function tests
Chemo/Radiation Therapy reports if applicable
Patient Education/Information (includes preps)
Cancer of the Esophagus
CT Test Prep
Endoscopic Ultrasound
PET Scan
GI/GU Test Preps
Appointment Timeframe
Next available appointment
Please complete
Outpatient Consult Request
Form and fax to 734-615-2656
How to Get Results to Consultant
UMHS Patients: See MiChart
External Patients: Hand carry films or CD's and slides to appointment; fax reports to 734-615-2656
Clinic Contact Information
Physicians: 800-962-3555
New Patients: 734-936-4973
Return Visit Patients: 734-936-8857
Clinic Location Sites
Taubman Health Center
UM Consulting Physician
Thoracic Surgery Faculty
Revised on:
02/06/2013