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Endoscopic Management of Gastric Polyp with Outlet Obstruction without Polypectomy

机译:胃息肉伴出口梗阻而无息肉切除术的内镜治疗

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摘要

Although gastric polyp is usually an incidental endoscopic finding, large-sized polyps can cause symptoms ranging from epigastralgia to bleeding from ulcerated polyps and gastric outlet obstruction. Although the gold standard of treatment is removal of the polyp either through endoscopic polypectomy or surgical excision, complications associated with these procedures cannot be ignored. The risk becomes a major concern for patients at high risk for surgery when complications arise. We describe a debilitated 74-year-old woman who presented with early satiety, intermittent postprandial nausea and vomiting for three months. Upper endoscopy revealed a 2.5 cm pedunculated polyp over the gastric antrum causing intermittent obstruction. Considering her high risk for polypectomy, detachable snaring was performed without polypectomy in an outpatient setting. The patient was complication-free with complete relief of obstructive symptoms one week after the procedure. Subsequent follow-ups showed satisfactory healing without signs of mucosal disruption or recurrence. The results suggest that detachable snaring without polypectomy may be a therapeutic option for high-risk patients with benign symptomatic gastric polyps.
机译:尽管胃息肉通常是内窥镜检查的偶然发现,但大型息肉会引起从上腹痛到溃疡性息肉出血和胃出口阻塞的症状。尽管治疗的金标准是通过内窥镜息肉切除术或外科手术切除息肉,但与这些手术相关的并发症也不容忽视。当发生并发症时,该风险成为高手术风险患者的主要关注点。我们描述了一个虚弱的74岁女性,她表现为饱腹感,餐后间歇性恶心和呕吐三个月。上消化道镜检查发现胃窦上方有一个2.5 cm的带蒂息肉,引起间歇性阻塞。考虑到她的息肉切除术风险很高,因此在门诊患者中不进行息肉切除术就进行了可拆卸式诱捕。手术后一周,患者无并发症,完全缓解了阻塞性症状。随后的随访显示愈合良好,没有粘膜破坏或复发的迹象。结果表明,对于没有症状的胃息肉的高危患者,无需进行息肉切除术的可分离式诱捕可能是一种治疗选择。

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