第一季案例答案公布(2011年10月10日)

第一期案例的答案公布如下,第一期案例原文在:http://www.uschie.org/web/zh/current/96-gi-club/934--20110830

 

Answer to the real case presentation by Dr. Z. John Chen in Session 1:

Because the large pedunculated polyp was located in the sigmoid colon, it can be reached using a double channel therapeutic upper endoscope.

I took advantage of the double channels of an Olympus GIF 2-T scope and used a rat-tooth forceps inserted through one channel to grab the polyp through a snare inserted through the other channel in what I described as “a tongue in the cheek” maneuver to successfully place the snare at the base of the pedunculated polyp stalk. The polyp was then successfully cut using the hot snare and retrieved using a Roth net. The pathology report did show a tubulovillous adenoma with focal high grade dysplasia but no invasive cancer. An endoclip was placed on the polypectomy site for hemorrhage prevention because the site was quite large and the patient was at high risk of bleeding complications. This case illustrates an example of novel use of GI equipment in special situations to solve practical problems.

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