Gus Attwell, MD

Professor, Medicine-Gastroenterology


FacultyPhoto
Medical School
  • MD, University of Texas Southwestern Medical Center at Dallas Southwestern Medical School (1998)
Undergraduate School
  • BA, Rice University (TX) (1994)
Internship
  • University of Colorado (University Hospital) Program (1999)
Residency
  • University of Colorado (University Hospital) Program, Internal Medicine (2001)
Fellowships
  • University of Colorado (University Hospital) Program, Gastroenterology (2004)
  • Medical University of South Carolina Program, Gastroenterology - advanced endoscopy (2005)
Languages
English, Spanish, French
Department
Medicine-Gastroenterology

Professional Titles

  • Staff gastroenterologist
  • Professor of Medicine

Recognitions

  • Faculty teaching award, Vanderbilt Medical School (2008)
    Outstanding teaching of fellows
  • Twinkle Award, Denver Health Medical Center (2012)
    Exceptional work recognized by a DH peer
  • Peak Performer Award, Rocky Mountain Hospital Medicine (2012)
    Clinical service
  • Star Award, Denver Health Medical Center (2014)
    Exceptional clinical service
  • Twinkle Award, Denver Health Medical Center (2017)
    Exceptional work recognized by a DH peer

Research Interests

Chronic pancreatitis, gallstones, adverse events of endoscopy

Publications

  • Attwell A, Borak G, Cotton P, Hawes R, and Romagnuolo J. Endoscopic pancreatic sphincterotomy for pancreas divisum by using a needle-knife or standard pull-type technique; safety and reintervention rates. Gastrointest Endosc 2006; 645:705-11
  • Attwell A and Hawes R. Surgical clip migration and choledocholithiasis: a late, abrupt complication of laparoscopic cholecystectomy. Dig Dis Sci online, Feb 2007
  • Attwell A, Dee E, Nash R, Russ P, and Shah R. Multiple myeloma involving the porta hepatis and peritoneum causing biliary obstruction and malignant ascites. Dig Dis Sci 2005; 50:1068-71
  • Attwell A and Chen Y. “Endoscopic Ligation in the Treatment of Esophageal Varices” in Wilcox CM, Techniques in gastrointestinal endoscopy, Philadelphia: Elsevier Press, Vol 7 (1): 18-25, Jan 2005
  • Attwell A, Ludkowski M, Nash R, and Kugelmas M. Treatment of Budd-Chiari syndrome in a liver transplant unit, the role of TIPS and liver transplantation. Alim Pharm Ther 2004; 20: 867-73
  • Attwell A, McEntyre R, Antillon M, and Chen YK. EUS-Guided Drainage of a diverticular abscess as an adjunct to surgical therapy. Gastrointest Endosc 2003; 58: 612-6
  • Attwell A and Kugelmas M. “Vascular Liver Diseases” Chapter 28, in McNally PR, GI/Liver Secrets, 3rd Ed., Philadelphia: Elsevier Inc., 2006
  • Attwell A, Laird SL, and Forman L. Combined angioplasty, TIPS and thrombolytic therapy for Budd-Chiari Syndrome associated with portal, mesenteric, and splenic vein thrombosis. ASGE Fellows Manual, Oct 2003
  • Vachon A, Attwell A. Migrated Surgical Mesh Masquerading as a Luminal Stent. Am J Gastroenterol. 2018 Nov 12. [Epub ahead of print] PubMed PMID: 30420633
  • Brimhall B, Han S, Tatman PD, Clark TJ, Wani S, Brauer B, Edmundowicz S, Wagh MS, Attwell A, Hammad H, Shah RJ. Increased Incidence of Pseudoaneurysm Bleeding With Lumen-Apposing Metal Stents Compared to Double-Pigtail Plastic Stents in Patients With Peripancreatic Fluid Collections. Clin Gastroenterol Hepatol. 2018 Sep;16(9):1521-1528. PubMed PMID: 29474970
  • Mittal C, Obuch JC, Hammad H, Edmundowicz SA, Wani S, Shah RJ, Brauer BC, Attwell AR, Kaplan JB, Wagh MS. Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video). Gastrointest Endosc. 2018 May;87(5):1263-1269. PubMed PMID: 29309781
  • Brewer Gutierrez OI, Bekkali NLH, Raijman I, Sturgess R, Sejpal DV, Aridi HD, Sherman S, Shah RJ, Kwon RS, Buxbaum JL, Zulli C, Wassef W, Adler DG, Kushnir V, Wang AY, Krishnan K, Kaul V, Tzimas D, DiMaio CJ, Ho S, Petersen B, Moon JH, Elmunzer BJ, Webster GJM, Chen YI, Dwyer LK, Inamdar S, Patrick VB, Attwell A, Hosmer A, Ko C, Maurano A, Sarkar A, Taylor LJ, Gregory MH, Strand DS, Raza A, Kothari S, Harris JP, Kumta NA, Manvar A, Topazian MD, Lee YN, Spiceland CM, Trindade AJ, Bukhari MA, Sanaei O, Ngamruengphong S, Khashab MA. Efficacy and Safety of Digital Single-Operator Cholangioscopy for Difficult Biliary Stones. Clin Gastroenterol Hepatol. 2018 Jun;16(6):918-926.e1. PubMed PMID: 29074446
  • Quach B, Han S, Attwell A. Septic shock after travel to rural Africa. Gastroenterology. 2019 Sep 24. [Epub ahead of print] PubMed PMID: 31560890
  • Mittal C, Obuch JC, Hammad H, Edmundowicz SA, Wani S, Shah RJ, Brauer BC, Attwell AR, Kaplan JB, Wagh MS. Technical feasibility, diagnostic yield, and safety of microforceps biopsies during EUS evaluation of pancreatic cystic lesions (with video). Gastrointest Endosc. 2018 May;87(5):1263-1269. PubMed PMID: 29309781
  • Brimhall B, Han S, Tatman PD, Clark TJ, Wani S, Brauer B, Edmundowicz S, Wagh MS, Attwell A, Hammad H, Shah RJ. Increased Incidence of Pseudoaneurysm Bleeding With Lumen-Apposing Metal Stents Compared to Double-Pigtail Plastic Stents in Patients With Peripancreatic Fluid Collections. Clin Gastroenterol Hepatol. 2018 Sep;16(9):1521-1528. PubMed PMID: 29474970
  • Brown NG, Camilo J, Nordstrom E, Yen RD, Fukami N, Brauer BC, Wani S, Amateau SK, Attwell AR, Shah RJ. Advanced ERCP techniques for the extraction of complex biliary stones: a single referral center's 12-year experience. Scand J Gastroenterol. 2018 May;53(5):626-631. PubMed PMID: 29644909
  • Vachon A, Attwell A. Migrated Surgical Mesh Masquerading as a Luminal Stent. Am J Gastroenterol. 2019 Jul;114(7):1023. PubMed PMID: 30420633
  • Machicado JD, Obuch JC, Goodman KA, Schefter TE, Frakes J, Hoffe S, Latifi K, Simon VC, Santangelo T, Ezekwe E, Edmundowicz SA, Brauer BC, Shah RJ, Hammad HT, Wagh MS, Attwell A, Han S, Klapman J, Wani S. Endoscopic Ultrasound Placement of Preloaded Fiducial Markers Shortens Procedure Time Compared to Back-Loaded Markers. Clin Gastroenterol Hepatol. 2019
  • Han S, Shah RJ, Brauer BC, Edmundowicz SA, Hammad HT, Wagh MS, Wani S, Attwell AR. A Comparison of Endoscopic Retrograde Pancreatography With or Without Pancreatoscopy for Removal of Pancreatic Duct Stones. Pancreas. 2019 May Jun;48(5):690-697. PubMed PMID: 31091217
  • Brewer Gutierrez OI, Bekkali NLH, Raijman I, Sturgess R, Sejpal DV, Aridi HD, Sherman S, Shah RJ, Kwon RS, Buxbaum JL, Zulli C, Wassef W, Adler DG, Kushnir V, Wang AY, Krishnan K, Kaul V, Tzimas D, DiMaio CJ, Ho S, Petersen B, Moon JH, Elmunzer BJ, Webster GJM, Chen YI, Dwyer LK, Inamdar S, Patrick VB, Attwell A, Hosmer A, Ko C, Maurano A, Sarkar A, Taylor LJ, Gregory MH, Strand DS, Raza A, Kothari S, Harris JP, Kumta NA, Manvar A, Topazian MD, Lee YN, Spiceland CM, Trindade AJ, Bukhari MA, Sanaei O, Ngamruengphong S, Khashab MA. Efficacy and Safety of Digital Single-Operator Cholangioscopy for Difficult Biliary Stones. Clin Gastroenterol Hepatol. 2018 Jun;16(6):918-926.e1. PubMed PMID: 29074446
  • Attwell A et al. In Memoriam: Brian C Brauer MD. Gastrointest Endosc 2020;
  • Adverse event fatalities related to GI endoscopy. Dig Dis Sci. In press, Jan 2021.
  • ERCP and liver biopsy in the evaluation of elevated liver function tests after liver transplantation. World J Hep. In press, Dec 2020.
  • Hepatocellular carcinoma presenting with obstructive jaundice and malignant hemobilia. JSM Case Reports. May 2020.
  • Fatal pharyngoesophageal perforation. Gastrointest Endosc 2020; S0016-5107(20); 30048-1 .
  • In Memoriam: Brian Brauer MD, FASGE. Gastrointest Endosc Jan 2020.
  • Timing of direct endoscopic necrosectomy through lumen-apposing metal stents for walled-off pancreatic necrosis impacts time to resolution. DDW 2020.
  • Iatrogenic esophageal perforation – a case series. DDW 2020.
  • Swei E, Heller JC, Scott F, Attwell A. Adverse Event Fatalities Related to GI Endoscopy. Dig Dis Sci. 2021 Apr 15. [Epub ahead of print] PubMed PMID: 33860417
  • Fatal endoscopic complications: trends from a retrospective analysis. DDW 2020.
  • Attwell A, Han S, Kriss M. Endoscopic retrograde cholangiopancreatography and liver biopsy in the evaluation of elevated liver function tests after liver transplantation. World J Hepatol. 2021 Jan 27;13(1):132-143. PubMed PMID: 33584992
  • Haydek J, Attwell A. Down to the wire: a case of GI bleeding after splenic artery coiling. In press. ACG Case Reports Journal 2021.
  • Septic Shock after Travel to Rural Africa. Gastroenterology. 2020 Jan;158(1):56-57
  • Pokala SK, Attwell A. Commentary on Effect of prophylactic endoscopic clipping for prevention of delayed bleeding after endoscopic papillectomy for ampullary neoplasm: a multicenter randomized trial. PracticeUpdate website. March 2022.
  • Haydek JP, Attwell AR. Down to the Wire: A Case of Gastrointestinal Bleeding After Splenic Artery Coiling. ACG Case Rep J. 2022 Jul;9(7):e00835. PubMed PMID: 35919410
  • Swei E, Heller JC, Scott F, Attwell A. Adverse Event Fatalities Related to GI Endoscopy. Dig Dis Sci. 2022 May;67(5):1753-1760. PubMed PMID: 33860417
  • Pokala S, Attwell A. Proximal biliary stent migration causing cardiac. ACG Case Reports Journal 2022; Vol. 9: 2, 322-4.
  • Montminy EM, Jones B, Heller JC, Attwell A. Endoscopic iatrogenic esophageal perforation and management: a retrospective outcome analysis in the modern era. BMC Gastroenterol. 2023 Oct 31;23(1):371. PubMed PMID: 37907880
  • Do M, Pokala SK, Yang MC, Attwell A. A Rare Cause of Abdominal Pain. Gastroenterology. 2024 Jan;166(1):e10-e12. PubMed PMID: 37393025
  • Attwell AR. Endoscopic Management of Necrotic Pancreatic Fluid Collections in the Setting of Disrupted Pancreatic Duct Syndrome: Out Like a LAMS?. Dig Dis Sci. 2023 Aug;68(8):3213-3215. PubMed PMID: 37269370
  • Pokala SK, Attwell AR. Proximal Biliary Stent Migration Causing Cardiac Tamponade. ACG Case Rep J. 2022 Dec;9(12):e00924. PubMed PMID: 36628372
  • Han S, Turkeltaub JA, Jonas D, Attwell AR, Duloy AM, Edmundowicz SA, Hammad HT, Wagh MS, Wani S, Shah RJ. The timing of recurrence after endoscopic papillectomy. Surg Endosc. 2024 Feb;38(2):688-696. PubMed PMID: 38015261
  • Enke T, Henn P, Attwell A. Symptomatic jejunal Dieulafoy’s lesion masquerading as a polyp. Gastrointest Endosc 2024, in press.
  • Montminy E, Attwell A. Iatrogenic esophageal perforations and their management. ACG Oct 2023.
  • Attwell A, Keniston A. Gastrointestinal endoscopy in incarcerated patients: a 6-year single-center experience. ACG 2023.
  • Do M, Pokala S, Attwell A. A rare presentation of gout. ACG 2023.
  • Goff S, Morton A, Attwell A, et al. Management of a pericardioesophageal fistula with endoluminal wound vacuum therapy. SAGES 2024.

Professional Memberships

  • American Society for Gastrointestinal Endoscopy, Fellow
  • American College of Gastroenterology, Member
  • American Gastroenterological Assocation, Fellow

Practice Locations

UCHealth Digestive Health Center - Anschutz Medical Campus
1635 Aurora Ct
5th Floor
Aurora, CO 80045
720-848-2777

Denver Health
777 Bannock St
Denver, CO 80204
303-436-6000

Pancreas & Biliary Multidisciplinary Clinic - Anschutz
1665 Aurora Ct
3rd Floor
Aurora, CO 80045
1-855-824-7262

Hospital Affiliation
  • University of Colorado Hospital
  • Denver Health Medical Center
  • Veterans Affairs Medical Center

Specialty Information

Specialties
  • Internal Medicine, Board Certification
  • Gastroenterology, Board Certification
  • Advanced endoscopy fellowship ERCP, Specialized Training (2005)
  • Advanced endoscopy fellowship EUS, Specialized Training (2010)
Conditions & Treatments
  • Digestive System - Gastroenterology (Stomach, Bowel, General GI Problems)
  • Digestive System - Therapeutic Endoscopy
  • Digestive System
Clinical Interests
My clinical interestes include pancreatic and biliary disease including gallstones, cancer, and pancreatitis; ERCP and endoscopic ultrasound

Care Philosophy
I strive to provide the best care for my patients. I believe in treating the person as a whole, taking not only disease but every aspect of a patient’s body and health, values, culture, and personality into consideration during diagnosis and treatment. I feel strongly about communicating the risks, benefits, and alternatives to treatment and having the patient be active in the discussion or decisions about his/her treatment. I believe that tests or treatment are appropriate when they make patients feel better, save or extend a life, or provide us/family with useful information. But I believe that unncessary, invasive tests or treatments that provide minimal information and do not result in improved quality of life should be avoided.

Personal Interests
Travel, running, swimming, golf, fishing, skiing, crosswords

Volunteer Activities
volunteer physician in indigent clinic/s, volunteer for animal rescue

Public Speaking
Yes
I give 3-4 oral presentations per year.