Endoscopic transgastric drainage of a gastric wall abscess after endoscopic submucosal dissection
| Autor: | Kazuhiko Tokita, Osamu Dohi, Masayasu Jo, Moyu Dohi, Yasuyuki Gen, Ken Inoue |
|---|---|
| Rok vydání: | 2013 |
| Předmět: |
Gastric Fistula
medicine.medical_specialty Abdominal Abscess Time Factors medicine.medical_treatment Fistula Perforation (oil well) Case Report Dissection (medical) Gastrectomy Recurrence Stomach Neoplasms Gastroscopy medicine Humans Abscess business.industry Dissection Gastroenterology Stent General Medicine Middle Aged medicine.disease Magnetic Resonance Imaging Early Gastric Cancer Surgery Anti-Bacterial Agents Treatment Outcome Drainage Female Stents Radiology business Tomography X-Ray Computed |
| Zdroj: | World journal of gastroenterology. 20(4) |
| ISSN: | 2219-2840 |
| Popis: | A 63-year-old woman was referred to our hospital for further examination because of an incidental finding of early gastric cancer. Endoscopic submucosal dissection (ESD) was successfully performed for complete resection of the tumor. On the first post-ESD day, the patient suddenly complained of abdominal pain after an episode of vomiting. Abdominal computed tomography (CT) showed delayed perforation after ESD. The patient was conservatively treated with an intravenous proton pump inhibitor and antibiotics. On the fifth post-ESD day, CT revealed a gastric wall abscess in the gastric body. Gastroscopy revealed a gastric fistula at the edge of the post-ESD ulcer, and pus was found flowing into the stomach. An intradrainage stent and an extradrainage nasocystic catheter were successfully inserted into the abscess for endoscopic transgastric drainage. After the procedure, the clinical symptoms and laboratory test results improved quickly. Two months later, a follow-up CT scan showed no collection of pus. Consequently, the intradrainage stent was removed. Although the gastric wall abscess recurred 2 wk after stent removal, it recovered soon after endoscopic transgastric drainage. Finally, after stent removal and oral antibiotic treatment for 1 mo, no recurrence of the gastric wall abscess was found. |
| Databáze: | OpenAIRE |
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