Gastroscopic polypectomy

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Tsuneoka and Uchida1 performed the first successful endoscopic polypectomy of the stomach. Newer techniques and instruments have made fiberoptic endoscopy a therapeutic as well as a diagnostic procedure. In the United States attention is presently centered on the management of colonic polyps by these means, but the techniques are applicable to both the upper and lower gastrointestinal tracts. A solitary gastric polyp removed under direct vision by a snare and electrocautery with the fiberoptic gastroscope is reported here.

Case report

A 74-year-old man was referred to the Cleveland Clinic for treatment of a 10- to 12-cm abdominal aortic aneurysm. The history also included moderate hypertension and symptoms of benign prostatic hypertrophy. Because the patient had complained of a burning sensation in the epigastrium the upper gastrointestinal tract was examined by roentgenography. This showed a smooth rounded lesion in the antrum, thought to be a leiomyoma (Fig. 1). Physical findings other than the aneurysm included a blood pressure of 190/108 mm Hg, Grade II prostatic hypertrophy, and a Grade III/VI left subclavian systolic bruit.

Gastroscopy was performed prior to aneurysmectomy. The cardia and fundus of the stomach were normal. A polyp approximately 0.6 cm in diameter and 1.2 cm in length was seen on the greater curvature of the midportion of the antrum. It was a deeper red than the surrounding mucous membrane, and there were two or three small areas of superficial ulceration overlying it (Figs. 2 and 3). The remainder of the antrum and pylorus were normal.

An abdominal . . .



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