ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand) | May 2023-Session 2 Video Case Discussion 1

Video Transcription

Video Summary

In this video, Dr. Peter Dragunov from the University of Florida discusses upper endoscopy challenges, specifically focusing on atrophic gastritis, intestinal metaplasia, and gastric dysplasia. He presents a case of a 60-year-old female with a family history of gastric cancer who exhibits chronic dyspepsia and intermittent bloating. Dr. Dragunov emphasizes the importance of performing high-quality endoscopy, including mucosal visibility and adequate distention of the stomach. He recommends spending at least seven minutes performing endoscopy in high-risk patients and using enhanced imaging to improve the detection of gastric metaplasia. The patient in the case undergoes endoscopy, revealing a large displaced lesion with gastric metaplasia, which is confirmed to be intramucosal adenocarcinoma. Dr. Dragunov explains that endoscopic resection can be offered for gastric neoplasia with a low risk of lymph node metastasis, and in this case, endoscopic submucosal dissection (ESD) is chosen. The final pathology confirms curative resection, but the patient requires long-term follow-up due to an increased risk of recurrent lesions.

Asset Subtitle

Saowanee Ngamruengphon

Keywords

upper endoscopy challenges

gastric metaplasia

endoscopic resection

intramucosal adenocarcinoma

long-term follow-up