BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint o...BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever.Laboratory tests showed mild leukocytosis and elevated C-reactive protein level.Computed tomography showed thickening of the esophageal wall.Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass.Spontaneous drainage occurred,and we could see purulent exudate from the crevasse.We closed the laceration with endoscopic clips.The patient did not remember swallowing a foreign body;however,she ate crabs before the symptoms occurred.We prescribed the patient with antibiotic,and the symptoms were gradually relieved.Two months later,upper endoscopy showed that the laceration was healed,and the submucosal abscess disappeared.However,intramural esophageal dissection was formed.We performed endoscopic incision of the septum using dual-knife effectively.CONCLUSION In conclusion,we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection.The significance of this case lies in clear presentation of the evolution process between two disorders.In addition,we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.展开更多
BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is t...BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.展开更多
文摘BACKGROUND Here we report a rare case of submucosal esophageal abscess evolving into intramural submucosal dissection.CASE SUMMARY An 80-year-old woman was admitted to our emergency department with a chief complaint of dysphagia and fever.Laboratory tests showed mild leukocytosis and elevated C-reactive protein level.Computed tomography showed thickening of the esophageal wall.Upper endoscopy showed a laceration of the esophageal mucosa and a submucosal mass.Spontaneous drainage occurred,and we could see purulent exudate from the crevasse.We closed the laceration with endoscopic clips.The patient did not remember swallowing a foreign body;however,she ate crabs before the symptoms occurred.We prescribed the patient with antibiotic,and the symptoms were gradually relieved.Two months later,upper endoscopy showed that the laceration was healed,and the submucosal abscess disappeared.However,intramural esophageal dissection was formed.We performed endoscopic incision of the septum using dual-knife effectively.CONCLUSION In conclusion,we are the first to report the case of esophageal submucosal abscess evolving into intramural esophageal dissection.The significance of this case lies in clear presentation of the evolution process between two disorders.In addition,we recommend that endoscopic incision be considered as one of the routine therapeutic modalities of intramural esophageal dissection.
文摘BACKGROUND There is a high annual incidence of acute,nonvariceal upper gastrointestinal bleeding in Chinese adults.Early endoscopic intervention can reduce rates of rebleeding,surgery,and mortality.The metal clip is the most common method for establishing homeostasis;however,it possesses several limitations.In patients with bleeding secondary to large gastric ulcers,the clip will often fail to stop the bleeding.This article highlights the use of an elastic traction ring as a novel hemostatic method for patients with upper gastrointestinal bleeding.CASE SUMMARY An elderly male presented to the emergency room with complaints of hematemesis and melena.Endoscopic examination revealed an ulcer(Forrest IIa)in the lesser curvature of the gastric antrum.Six tissue clips and one elastic traction ring were inserted into the stomach cavity to suture the ulcer.The patient recovered quickly without postoperative gastrointestinal bleeding.Two months later,the patient's ulcer was significantly healed.CONCLUSION To our best knowledge,this is the first report to demonstrate the safety and efficacy of elastic traction rings for upper gastrointestinal bleeding.Elastic traction rings should be considered a routine therapeutic modality for patients with upper gastrointestinal bleeds.
