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Early gastric cancer with ball valve syndrome treated by endoscopic submucosal dissection. | LitMetric

Early gastric cancer with ball valve syndrome treated by endoscopic submucosal dissection.

Clin J Gastroenterol

Department of Gastroenterology and Hepatology, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710-8602, Japan.

Published: August 2019

AI Article Synopsis

  • An 84-year-old woman with multiple health issues presented with iron-deficiency anemia and decreased appetite, leading to a diagnosis of a gastric tumor.
  • An endoscopic procedure revealed a 60-mm tumor in her stomach that was causing complications, including bleeding and prolapsing into the duodenal bulb.
  • Despite initial difficulties, the tumor was successfully removed using endoscopic submucosal dissection, and it was identified as a well-differentiated adenocarcinoma, suggesting this method can be a viable option for similar cases.

Article Abstract

An 84-year-old woman with pneumonia, congestive heart failure and chronic renal failure presented for iron-deficiency anemia and appetite loss. Esophagogastroduodenoscopy revealed a 60-mm sub-pedunculated tumor arising from the antrum of the stomach. The tumor was friable, with bleeding, and prolapsed into the duodenal bulb, the ball valve syndrome. The tumor was considered the cause of the anemia and appetite loss. Attempted endoscopic reduction of the prolapsing tumor was unsuccessful, but the base of its stalk could be identified through the transparent hood; thus, we removed the tumor with endoscopic submucosal dissection. The tumor was retrieved successfully, and pathohistological examination revealed the tumor to be a well-differentiated adenocarcinoma. This case suggests that endoscopic submucosal dissection is useful as an alternative to surgery for removal of gastric tumors that have prolapsed into the duodenal bulb when polypectomy was difficult, but provided the tumor's attachment site can be identified endoscopically.

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Source
http://dx.doi.org/10.1007/s12328-019-00955-1DOI Listing

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