ASGE Annual Postgraduate Course: Clinical Challenges and Real-Time Decision Making in GI Endoscopy (On-demand)

Yang_ASGE Post Grad UGI Lesions

Pdf Summary

The document discusses commonly encountered upper gastrointestinal (GI) lesions and their management. It starts by presenting two clinical cases and discussing their significance, work-up, management, and surveillance. The first case involves a woman with anemia and well-differentiated neuroendocrine tumor in the stomach. The second case involves a man with non-alcoholic fatty liver disease cirrhosis and gastric hyperplastic polyps.<br /><br />The document provides information about gastric neuroendocrine tumors (G-NETs), which originate from histamine-secreting, enterochromaffin-like cells. It describes the three types of G-NETs (Type I, Type II, and Type III) and their associated conditions, endoscopic features, gastric pH, histology, and prognosis. The evaluation, including endoscopy with biopsies and various lab tests, and management options for each type are also discussed.<br /><br />The document also discusses gastric hyperplastic polyps (GHPs), their causative agents, and risk factors for neoplastic transformation. It mentions the recurrence rate after endoscopic resection and factors that influence it, such as the presence of portal hypertension. The document provides recommendations for resecting GHPs based on their size, associated mucosal pathology, and the risk/benefit ratio.<br /><br />In conclusion, the document emphasizes the importance of tailoring the management approach for G-NETs based on their subtype and provides recommendations for the surveillance and resection of GHPs based on their size and associated factors. It highlights the need to evaluate the entire stomach in both G-NETs and GHPs, and not just focus on the lesions themselves.

Keywords

upper gastrointestinal lesions

management

clinical cases

neuroendocrine tumor

gastric hyperplastic polyps

G-NETs

endoscopic features

evaluation

endoscopy

resection