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Poster Session : PS 0820 ; Upper GI Tract : A Case of Bleeding Gastric Gist Resected by Two-Stage Snaring with Spontaneous Enucleation
( Hyo Jin Cho ) , ( Ju Sang Park ) , ( Jung Hee Kim ) , ( Dong Ok Jeon )
UCI I410-ECN-0102-2015-500-000126267
이 자료는 4페이지 이하의 자료입니다.

Introduction: Gastrointestinal stromal tumor (GIST) has the possibility of malignancy regardless of its size, so it has to be resected completely without rupturing the tumor. Surgical resection is considered to be a treatment of choice. Recently, with the development of endoscopic technique and devices, endoscopic enucleation of GIST has been reported. Authors report a case of an 88-year-old female with bleeding gastric GIST. This patient was treated by two-stage snaring with spontaneous enucleation. Case: An 88-year-old female was admitted with melena. Hemoglobin concentration was 3.6 mg/dl. Gastroduodenoscopy showed an approximately 5 cm-sized subepithelial tumor with a central ulcer covered with blood clots at the fundus. Subsequently, the tumor was confi rmed as GIST. The tumor needed to be removed upon considering the bleeding complication, but the patient was not suitable to have surgery due to poor general condition. We thus decided to perform endoscopic enucleation to remove the tumor. Although initial mucosectomy was attempted, the procedure time was prolonged due to severe bleeding from the incision site. Therefore, partial resection of GIST including bleeding point using snare was used to prevent only further bleeding. On followe-up endoscopic examination, a remnant tumor was exposed spontaneously because swelling mucosa surrounding that tumor by submucosal injection contracted. Therefore, remnant GIST was easily resected by additional snaring. Histopathology confi rmed intermediate-risk GIST. Conclusions: We resected bleeding gastric GIST by unscheduled two-stage snaring with spontaneous enucleation. Two-stage snaring with spontaneous enucleation can apply to patients who cannot have the surgery due to poor general condition or comorbidities or whose procedure is expected to take a long time due to tumor location or size.

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