VIDEO PLENARY 1: VID-LUM-03: Endosonographic yin yang sign for identifying aneurysm in wall-off necrosis

S35 ENDOSCOPIC ULTRASOUND / VOLUME 6 / SUPPLEMENT 1 / AUGUST 2017 VID-LUM-01 A case of “rolling” esophagus lumps and bumps Keat Hong Lee, How Cheng Low, Gim Hin Ho National University Hospital, Singapore Case Report: A 47-year-old gentleman was referred from GP clinic for postprandial abdominal bloating for 2 months associated with early satiety. There was no weight loss/ dysphagia/odynophagia/nausea/vomiting. His medical history includes hypertension and dyslipidemia, for which he is on treatment. Physical examination was unremarkable. Esophagogastroduodenoscopy (OGD) followed by endoscopic ultrasound (EUS) were performed. OGD showed rounded esophageal subepithelial “nodules” located at 27–30 from incisors. These nodules seemed to move with peristalsis. The overlying esophagus mucosa appeared normal. Subsequently, EUS was done which confirmed that these nodules were in fact the result of external compression by the thoracic vertebrae, hence the OGD findings. Discussion: Subepithelial lesions (SELs) are usually discovered incidentally in the esophagus during routine upper gastrointestinal endoscopy. SELs can be either intramural (e.g., leiomyoma, gastrointestinal stromal tumor, lipoma, etc.) or extramural (aneurysm, lymph node, spine, etc.). EUS is useful in the diagnosis of esophageal SELs because of good sensitivity as well as specificity. Thoracic spine indentation of the esophagus is rarely symptomatic but may cause symptoms such as dysphagia or even erosion in severe cases. DOI: 10.4103/2303-9027.212275