Gastric intramural hematoma caused by argon plasma coagulation: Treated with endoscopic incision and drainage (with videos)

摘要

A 71-year-old woman underwent endoscopic submu-cosal dissection (ESD) to remove a flat adenoma on the anterior aspect of the distal gastric body. The resected lesion was a 25-mm tubular adenoma with low-grade dysplasia and lateral margin involvement. Additional endoscopic therapy was planned to ablate the remnant lesion after 4 weeks. On endoscopy, the ESD wound was completely healed. To ablate the remnant lesion, argon plasma coagulation (APC) was used, with power of 60 watts and gas flow of 2 L/minute after saline solution injection. On the following day, the patient had epigastric pain and melena. On follow-up endoscopy, a large, intramural hematoma was observed on the lower body greater curvature, next to the ablation site (Fig. 1). The hematoma extended from the lower body to the prepyloric antrum (Video 1, available online at www.giejournal.org).