Video Tip: Diagnosing Clip Artifact | October 2022-Diagnosing Clip Artifact

Video Transcription

This ASG video tip is brought to you by an educational grant from Braintree, a part of Cibela Pharmaceuticals, makers of SUTAB.  This video is from a 64 year old man that you referred for endoscopic mucosal resection of a large lesion on the lateral wall of the cecum.  And this is the EMR defect, it was seen first in white light and now we're looking at it in narrow band imaging.  We also have the close focus on to examine the scar which has this irregular and nodular appearance, a number of small polyploid structures that are on the surface of the EMR scar.  The correct diagnosis is clip artifact. At the time of the EMR, clips were placed to prevent delayed hemorrhage and the clip artifact that we're seeing here is mature clip artifact.  Initially, this develops as granulation tissue around the base of the adherent clip. Then after the clip falls off, the inflammation subsides and leaves this distorted mucosa,  small nodules of normal tissue, which we can tell are normal by their pit pattern, neither adenominous nor serrated pits present.  Essential to recognize this as normal, no evidence of residual polyp.  For more information, visit www.ISGlobal.org

Video Summary

This video discusses a case of endoscopic mucosal resection (EMR) performed on a 64-year-old man with a large lesion on the lateral wall of the cecum. The video shows the EMR defect in both white light and narrow band imaging, with a focus on the scar which has an irregular and nodular appearance. The diagnosis is clip artifact, which occurs when clips are placed during the EMR procedure to prevent bleeding. The video explains that clip artifact initially appears as granulation tissue around the clip, which later subsides, leaving distorted mucosa and small nodules of normal tissue. It emphasizes the importance of recognizing this as normal and not residual polyp. This video is supported by an educational grant from Braintree, a part of Cibela Pharmaceuticals, makers of SUTAB. For more information, visit www.ISGlobal.org.

Keywords

endoscopic mucosal resection

EMR

cecum

clip artifact

scar appearance