Endoscopic submucosal dissection for the diagnosis and treatment of a gastric submucosal tumor: initial experience in Greece.

Gastric submucosal tumors (GSMTs) are frequently found incidentally on routine upper endoscopy. Definitive diagnosis based on histological confirmation is relatively difficult. Even without accurate diagnosis before treatment, open or laparoscopic surgery is considered the standard of care for most GSMTs. Alternatively, endoscopic resection of GSMTs using different techniques has been reported in a limited number of papers. We describe a case of an antral submucosal tumor, more specifically a leiomyoma of muscularis mucosa origin, in a 78-year-old woman, that was completely resected en bloc using an endoscopic submucosal technique with a TT-knife. It is suggested that ESD is a feasible option for the diagnosis and treatment of GSTMs.

Capsule endoscopy retention as a helpful tool in the management of a young patient with suspected small-bowel disease.

Capsule endoscopy is an easy and painless procedure permitting visualization of the entire small-bowel during its normal peristalsis. However, important problems exist concerning capsule retention in patients at risk of small bowel obstruction. The present report describes a young patient who had recurrent episodes of overt gastrointestinal bleeding of obscure origin, 18 years after small bowel resection in infancy for ileal atresia. Capsule endoscopy was performed, resulting in capsule retention in the distal small bowel. However, this event contributed to patient management by clearly identifying the site of obstruction and can be used to guide surgical intervention, where an anastomotic ulcer is identified.