Korean J Gastroenterol.  2016 Mar;67(3):142-145. 10.4166/kjg.2016.67.3.142.

Perigastric Abscess as a Complication of Endoscopic Submucosal Dissection for Early Gastric Cancer: First Case Report

• Jung JY
• Kim JS
• Kim BW
• Park SM
• Kim GJ
• Ryu SJ
• Kim YW
• Ji JS
• Choi H

• KMID: 2373414
• DOI: http://doi.org/10.4166/kjg.2016.67.3.142

Abstract

Endoscopic submucosal dissection (ESD) for early gastric cancer (EGC) is a widely accepted and well established procedure because of its curative potential and low invasiveness compared with surgery. Perforation is a potential major complication during ESD, and non-surgical treatments such as endoscopic closure with clips are sufficient in most cases. Here, we report a case of perigastric abscess that occurred as a complication of ESD for EGC. The patient improved with administration of antibiotics without surgical intervention.

Keyword

Endoscopic submucosal dissection; Early gastric cancer; Perigastric abscess

MeSH Terms

Abscess/*etiology
Adenocarcinoma/pathology/surgery
Endoscopic Mucosal Resection/*adverse effects
Female
Gastric Mucosa/surgery
Humans
Middle Aged
Neoplasm Staging
Stomach Neoplasms/pathology/*surgery
Tomography, X-Ray Computed

Figure

• 

  Fig. 1. Procedure of endoscopic submucosal dissection for the lesion. (A) A slightly depressed intramural hemorrhagic lesion is noted at the lesser curvature side of the distal corpus. (B) After spraying indigo carmine, marking was done with argon plasma laser.(C) Precut with hook knife was performed. (D) Dissection of the submucosal layer was performed.

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  Fig. 2. (A) Chest radiograph immediately after endoscopic submucosal dissection. Intraperitoneal free air is noted on the right subdiaphragmatic area (arrow). (B) Chest radiograph 4 days after Endoscopic submucosal dissection. The amount of intraperitoneal free air markedly decreased (arrow).

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  Fig. 3. Initial abdominal computed tomography. It reveals loculated fluid collection at the perigastric area of fundus (arrow).

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  Fig. 4. Abdominal computed tomography after 5 weeks. It shows resolution of the previous perigastric fluid collection (arrow).

Reference

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