Abstract
A female in her 70s underwent esophagogastroduodenoscopy (EGD) for screening, and a 0-IIa lesion measuring approximately 15 mm was detected in the descending portion of the duodenum. Due to the malignant potency of the lesion, endoscopic submucosal dissection (ESD) was performed. Microperforation occurred during ESD. The lesion was removed en bloc and the post-ESD ulcer bed was closed with clips. The next day, the patient had abdominal pain and computed tomography (CT) revealed a small amount of free air in the retroperitoneal space. Since there were no findings to suggest panperitonitis, conservative medical management including fasting and antibiotics was continued. Abdominal pain subsequently improved. However, EGD on the 8th day after ESD for follow-up showed shedding of the post-ESD ulcer that penetrated the retroperitoneal space. A surgical approach was not indicated because a few days may have already passed since postoperative perforation occurred and the spread of inflammation to the retroperitoneum was suspected. In an attempt to promote closure of the perforated cavity, we patched polyglycolic acid sheets and fibrin glue to the cavity wall on days 17, 18, and 20 after ESD. The formation of granulation tissue was dete...Continue Reading
References
Mar 10, 2009·Interactive Cardiovascular and Thoracic Surgery·Tomohiro ManiwaYukihito Saito
Nov 18, 2011·World Journal of Surgery·Tokujiro YanoYoshihiko Maehara
Jan 25, 2012·Endoscopy·A RepiciR Marmo
Oct 12, 2012·Surgical Endoscopy·Takashi ToyonagaTakeshi Azuma
Dec 12, 2012·Japanese Journal of Clinical Oncology·Takeshi ShinozakiToshifumi Tomioka
Feb 2, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hirohito MoriTsutomu Masaki
Apr 30, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Takuya InoueHiroaki Ohigashi
Apr 30, 2013·The Annals of Thoracic Surgery·Seokkee LeeChang Young Lee
Oct 22, 2013·Gastrointestinal Endoscopy·Yosuke TsujiKazuhiko Koike
Apr 23, 2014·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hisashi DoyamaShinya Yamada
Apr 23, 2014·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Kengo TakimotoKiichi Matsuyama
Apr 23, 2014·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Yorimasa YamamotoMasahiro Igarashi
Aug 30, 2014·Gut and Liver·Keun Young ShinChang Hun Yang
Dec 3, 2014·Gastrointestinal Endoscopy·Yosuke TsujiKazuhiko Koike
Apr 1, 2015·Endoscopy·Yoshiki TsujiiTetsuo Takehara
Dec 1, 2013·Endoscopy International Open·Shu HoteyaMitsuru Kaise
Mar 19, 2016·Gastrointestinal Endoscopy·Yoshiki SakaguchiKazuhiko Koike
Aug 23, 2016·World Journal of Gastroenterology : WJG·Shintaro FujiharaTsutomu Masaki
Aug 25, 2016·Endoscopy International Open·Kengo Takimoto, Akeo Hagiwara
Nov 3, 2016·Internal Medicine·Kazuhiro FurukawaHidemi Goto
Jan 5, 2017·Digestion·Shu HoteyaMitsuru Kaise
Jan 7, 2017·World Journal of Gastroenterology : WJG·Daisuke IchikawaEigo Otsuji
Apr 2, 2017·Clinical Journal of Gastroenterology·Ryo TakahashiJunko Fujisaki
Citations
Aug 14, 2019·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Vincent Zimmer
Sep 27, 2018·Surgical Endoscopy·Yoshiko NakanoYuzo Kodama
Sep 2, 2018·Clinical Journal of Gastroenterology·Umaporn SeehawongYuzo Kodama
Dec 8, 2019·Medical Hypotheses·Maximos FrountzasKonstantinos Toutouzas
Jun 18, 2021·European Surgical Research. Europäische Chirurgische Forschung. Recherches Chirurgicales Européennes·Maximos FrountzasKonstantinos G Toutouzas