A rare case of disseminated intravascular coagulation after endoscopic submucosal dissection for early gastric cancer.
نویسندگان
چکیده
cancer (EGC) is currently standard practice in Korea and Japan [1]. Although there are many causes of disseminated intravascular coagulation (DIC), it occurs mostly after sepsis, wide tissue damage, and obstetric complications [2]. The authors report a case of DIC after endoscopic submucosal dissection (ESD), which has never been reported before. A 75-year-old female patient had been diagnosed with EGC. The patient had no specific medical history and blood tests were normal. ESD was performed on the second day of hospitalization (l" Fig. 1). At 4 hours after ESD, the patient showed hematemesis. Endoscopic bleeding was immediately controlled using hemoclips (l" Fig. 2). The following day, blood test results showed a decrease in platelet number (60000/ L) and the international normalized ratio was increased to 1.8. Other results were fibrinogen 140mg/dL and fibrin degradation product 32 g/mL. Schistocytosis was observed on a peripheral blood smear (l" Fig. 3). The patient was diagnosed with DIC based on test results and clinical evidence. There was no additional bleeding and DIC improved under observation. ESD has the advantage over surgery of less tissue damage. DIC is generally known to occur after serious tissue injuries. A combination of mechanisms, including release of fat and phospholipids from tissue into circulation, hemolysis, and endothelial damages, may promote the systemic activation of coagulation [2]. The interesting fact in this case is that DIC occurred after ESD, which is a procedure that causes relatively little tissue damage. Until now there has been no report of DIC after ESD. Another cause for DIC could be cancer itself; about 10%– 15% of patients with metastasized tumors have evidence of DIC [2]. However, there have been no reports of DIC in EGC A rare case of disseminated intravascular coagulation after endoscopic submucosal dissection for early gastric cancer
منابع مشابه
Phlegmonous Gastritis with Early Gastric Cancer
Phlegmonous gastritis is a rare and rapidly progressive bacterial infection of the stomach wall, with a high mortality rate. Antibiotics with or without surgical treatment are required for treatment. We present a case in which phlegmonous gastritis occurred during the diagnostic evaluation of early gastric cancer. The patient showed improvement after antibiotic treatment, but attempted endoscop...
متن کاملSuccessful endoscopic submucosal dissection for early gastric cancer adjacent to gastric cardia varix
A 58-year-old man with liver cirrhosis and renal failure was diagnosed with esophageal varices (EVs) and a gastric cardia varix (GCV) by esophagogastroduodenoscopy (EGD). The patient also exhibited early gastric cancer (EGC) in the upper gastric body adjacent to the GCV. The EVs and GCV were treated using endoscopy before endoscopic submucosal dissection (ESD) of the EGC to prevent variceal ble...
متن کاملDisseminated Intravascular Coagulation in a Case of Brucellosis Misdiagnosed as Thrombotic Thrombocytopenia Purpura
متن کامل
The Clinical Significance and Management of Noncurative Endoscopic Resection in Early Gastric Cancer
Nowadays, endoscopic mucosal resection or endoscopic submucosal dissection has shown effectiveness equivalent to that of gastrectomy and has emerged as a popular technique for curative treatment of gastric cancer. However, noncurative resection or resection beyond the indication may lead to lymphatic and extended organ metastasis resulting in loss of the opportunity for full recovery. Therefore...
متن کاملMetachronous Liver Metastasis Resulting from Early Gastric Carcinoma after Subtotal Gastrectomy Following Endoscopic Resection: A Case Report
Hepatic metastasis of early gastric cancer (EGC) following subtotal gastrectomy with lymphadenectomy is rare. We report the case of a 61-year-old male patient who was diagnosed with EGC that was initially treated using endoscopic submucosal dissection (ESD) and subsequently underwent laparoscopic subtotal gastrectomy. Histopathological examination of the patient's ESD specimen showed a moderate...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Endoscopy
دوره 42 Suppl 2 شماره
صفحات -
تاریخ انتشار 2010