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A Rare Case of Early Gastric Cancer Combined with Underlying Heterotopic Pancreas
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Jung Bin Yoon, Bong Eun Lee, Dae Hwan Kim, Do Youn Park, Hye Kyung Jeon, Dong Hoon Baek, Gwang Ha Kim, Geun Am Song
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Clin Endosc 2018;51(2):192-195. Published online August 31, 2017
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DOI: https://doi.org/10.5946/ce.2017.055
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Abstract
PDFPubReaderePub
- Heterotopic pancreas in the stomach is usually asymptomatic and benign. Here, we presented a rare case of an early gastric cancer overlying a heterotopic pancreas. A 48-year-old woman underwent esophagogastroduodenoscopy, which revealed a subepithelial mass measuring 2.0×1.5 cm on the gastric antrum with a 1-cm erosive erythematous discoloration on the surface. A biopsy specimen showed moderately differentiated tubular adenocarcinoma. Endosonography showed a heterogeneous hypoechoic mass measuring 1.3×0.6 cm, with indistinct margins in the second and third layers of the gastric wall; anechoic tubular structures within the mass were suggestive of heterotopic pancreas. Distal gastrectomy was performed, which confirmed an early gastric cancer confined to the mucosa, and a separate underlying heterotopic pancreas. Although heterotopic pancreas is most likely benign, careful endoscopic observation of the mucosal surface is necessary to avoid overlooking a coincident early gastric cancer.
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Citations
Citations to this article as recorded by
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Shinya Kawaguchi, Akinori Murakami, Masato Nishida Internal Medicine.2023; 62(5): 723. CrossRef - Gastric ectopic pancreas combined with synchronous multiple early gastric cancer: A rare case report
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Keiso Matsubara, Michihiro Ishida, Toshiaki Morito, Tetsushi Kubota, Yasuhiro Choda, Masao Harano, Hiroyoshi Matsukawa, Hitoshi Idani, Shigehiro Shiozaki, Masazumi Okajima International Journal of Surgery Case Reports.2020; 74: 284. CrossRef - A case of gastric heterotopic pancreas with gastroduodenal invagination
Shoko Iwahashi, Masaaki Nishi, Toshiaki Yoshimoto, Hideya Kashihara, Chie Takasu, Takuya Tokunaga, Tomohiko Miyatani, Jun Higashijima, Kozo Yoshikawa, Yuma Wada, Yoshimi Bando, Mitsuo Shimada Surgical Case Reports.2019;[Epub] CrossRef
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Second-Look Endoscopy after Endoscopic Submucosal Dissection: Can We Obtain Valuable Information?
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Hye Kyung Jeon, Gwang Ha Kim
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Clin Endosc 2016;49(3):212-213. Published online May 9, 2016
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DOI: https://doi.org/10.5946/ce.2016.062
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Citations
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- Bleeding Risk Factors after Endoscopic Submucosal Dissection in Early Gastric Cancer and the Necessity of “Second-Look” Endoscopic Examination on the following Day
Rika Kobayashi, Ken Kawaura, Tohru Ito, Sadafumi Azukisawa, Hiroaki Kunou, Junji Kamai, Kazu Hamada, Tsuyoshi Mukai, Hidekazu Kitakata, Yasuhito Ishigaki Journal of Clinical Medicine.2022; 11(4): 914. CrossRef
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Endoscopic Management of Dieulafoy's Lesion
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Hye Kyung Jeon, Gwang Ha Kim
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Clin Endosc 2015;48(2):112-120. Published online March 27, 2015
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DOI: https://doi.org/10.5946/ce.2015.48.2.112
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Abstract
PDFPubReaderePub
A Dieulafoy's lesion is a vascular abnormality consisting of a large caliber-persistent tortuous submucosal artery. A small mucosal defect with the eruption of this protruding vessel can cause bleeding. In fact, a Dieulafoy's lesion is a relatively rare but potentially life-threatening condition. It accounts for 1% to 2% of cases of acute gastrointestinal bleeding. Although there is no consensus on the treatment of Dieulafoy's lesions; treatment options depend on the mode of presentation, site of the lesion, and available expertise. Endoscopic therapy is usually successful in achieving primary hemostasis, with hemostasis success rates reaching 75% to 100%. Although various therapeutic endoscopic methods are used to control bleeding in Dieulafoy's lesions, the best method for endoscopic intervention is not clear. Combination endoscopic therapy is known to be superior to monotherapy because of a lower rate of recurrent bleeding. In addition, mechanical therapies including hemostatic clipping and endoscopic band ligation are more effective and successful in controlling bleeding than other endoscopic methods. Advances in endoscopic techniques have reduced mortality in patients with Dieulafoy's lesion-from 80% to 8%-and consequently, the need for surgical intervention has been reduced. Currently, surgical intervention is used for cases that fail therapeutic endoscopic or angiographic interventions.
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