Clinical Endoscopy

Perforation of a Gastric Tear during Esophageal Endoscopic Submucosal Dissection under General Anesthesia: Tomoaki Yamasaki, Yuhei Sakata, Takehisa Suekane, Hiroko Nebiki; Clin Endosc 2021;54(6):916-919. Published online November 12, 2020; DOI: https://doi.org/10.5946/ce.2020.220

Mallory-Weiss tears (MWT) are occasionally encountered during endoscopic procedures. Esophageal endoscopic submucosal dissection (ESD) is widely performed under general anesthesia to avoid unexpected body movements. We present the case of a 68-year-old woman with squamous cell carcinoma. Although ESD was performed under general anesthesia, a gastric perforation at the MWT caused by gastric inflation was observed after the procedure. The perforation was closed endoscopically, and she was discharged without any sequelae. Although general anesthesia is useful for esophageal ESD, it should be noted that it can cause MWT, and in rare cases, gastric perforation, due to gastric inflation during the procedure.

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Gastric Perforation Encountered during Duodenal Stent Insertion
Sung Woo Ko, Hoonsub So, Sung Jo Bang
The Korean Journal of Gastroenterology.2022; 80(5): 221. CrossRef

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A Case of Gastric Perforation due to Endoscopic Mucosal Resection Managed by Detachable Snare and Hemoclips: Dong Won Lee, M.D., Sung Gyu An, M.D., Sun Mi Lee, M.D., Seong Hun Lee, M.D., Tae Oh Kim, M.D., Jeong Heo, M.D., Gwang Ha Kim, M.D., Dae Hwan Kang, M.D., Geun Am Song, M.D., Mong Cho, M.D. and Do Youn Park, M.D.*; Korean J Gastrointest Endosc 2005;30(4):199-203. Published online April 30, 2005

Abstract PDF: The detachable snare, by Pontecorvo and Pesce in 1986, was designed for the prevention of bleeding after endoscopic mucosal resection (EMR) of a polyp. It has been used widely for the ligation of large gastric or duodenal variceal bleeding, and even for the resection of a colon polyp. But detachable snare has been rarely used in the treatment of gastric perforation after the EMR. Herein, we report a successful case of detachable snare application in the treatment of gastric perforation caused by EMR in a patient with gastric adenoma measuring 1.6⁓1.6 cm in size, along with the review of relevant literatures. (Korean J Gastrointest Endosc 2005;30:199⁣203)

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위평활근종에 의한 위 천공 1예 ( A Case with Perforated Gastric Leiomyoma ): Korean J Gastrointest Endosc 1993;13(1):61-64. Published online November 30, 1992

Abstract PDF: Gastric leiomyomas, which arise from smooth muscle tissue, are the most common non-epi- thelial tumors occurring in the stomach. This tumor is most commonly found incidentally at surgery or autopsy. The incidence of the leiomyoma is about 1-3% of all gastric tumors and sex distribution is equal. We have recently experienced a 59-year-old housewife who had epigastric pain and soreness of one month's duration. Physical examination disclosed tenderness with palpated mass in the left upper quadrant. Gastrofiberscopic finding revealed esophageal diverticulum in the mid-esophagus and 2 x 2 x 1 cm sized submucosal intramural mass with centrally depressed umbilication through ulcerative change on the greater curvature of lower body. Within the umbilication, there were food materials and blood clots. The sleeve segmental resection of stomach was performed. The histopathologic and post operative findings were atypical leiomyoma, perforated with abscess formation to the omentum.

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