Clinical Endoscopy  2012;45(2):169-173

doi:10.5946/ce.2012.45.2.169

Successful Treatment of Early Gastric Cancer Adjacent to a Fundal Varix by Endoscopic Submucosal Dissection and Endoscopic Cyanoacrylate Therapy.

Yeon Soo KIM 1 ; Won Young CHO ; Joo Young CHO ; So Young JIN

Affiliations

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Keywords

Endoscopic submucosal dissection; Endoscopic variceal obturation; Early gastric cancer; Esophageal and gastric varices

Country

Republic of Korea

Language

English

Abstract

Endoscopic submucosal dissection (ESD) was developed for the en bloc resection of large early gastrointestinal neoplasms. A disadvantage of ESD is its technical difficulty, which requires advanced skills and is associated with a higher rate of complications. Endoscopic variceal obturation (EVO) using cyanoacrylate has emerged as the initial treatment of choice for acute gastric variceal bleeding. This procedure achieves hemostasis in 90% of cases. A 52-year-old patient with Child A alcoholic liver cirrhosis presented with early gastric cancer in the cardia and type 1 isolated gastric varices in the fundus. The two lesions were so close together that treatment was not easy. The lesions were managed successfully with a combination of ESD and EVO using cyanoacrylate.