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Gastric mucosal laceration managed with endoscopic clipping during ESD in a patient with Child Class A liver cirrhosis

Gf Donatelli, MD P Dhumane, MD L Marx, MD B Dallemagne, MD J Marescaux, MD, FACS, Hon FRCS, Hon FJSES, Hon FASA, Hon APSA
Epublication WebSurg.com, Mar 2012;12(03). URL: http://websurg.com/doi/vd01en3380

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  • 2012-03-15
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Patients with liver cirrhosis present with portal hypertension (PHT), which causes various pathological changes in the entire gastrointestinal tract (from esophagus to anus). In this video, the Mallory Weiss tear (MWT) occurred accidentally during ESD of a gastric antral adenoma in a cirrhotic patient. It was successfully managed by means of endoscopic clipping. The patient had two episodes of retching during endoscopy, which might have contributed to gastric over-distension. With esophagogastroduodenoscopy (EGD) being so commonly performed in cirrhotic patients and ESD being more and more commonly used for treatment of gastric mucosal lesions, this case report should serve as a precautionary reminder in such case scenarios.