PMC6186326_01
(a, b) ESD. (c) Abdominal CT (day 3 post-ESD). (d) Abdominal CT (day 20 post-ESD).
CRIGM2018-8046817.001.jpg
PMC6186326_01_CRIGM2018-8046817.001.jpg
fig1
Her temperature spiked to around 38 C that day, and post-ESD abdominal computed tomography (CT) was performed on day 3 (Figure 1(c)), which showed full-circumference thickening of the gastric wall. Abdominal CT performed on day 20 post-ESD (Figure 1(d)) showed full-circumference thickening of the gastric wall and increased levels of perigastric fat stranding.
Post-ESD course. Transition of WBC, CRP, body temperature, and course of treatment.
CRIGM2018-8046817.002.jpg
PMC6186326_01_CRIGM2018-8046817.002.jpg
fig2
Post-ESD course (Figure 2): No bleeding was observed on repeat endoscopy performed the day after ESD; therefore, the patient was allowed to eat.
Upper endoscopy (day 29 post-ESD), (a) ulcer, (b) yellow mucus, and (c, d) ulcer and false lumen.
CRIGM2018-8046817.003.jpg
PMC6186326_01_CRIGM2018-8046817.003.jpg
fig3
On day 29 post-ESD, upper endoscopy was performed (Figure 3) because the patient began experiencing epigastric pain after eating on day 27 post-ESD.
(a) day 37 post-ESD, (b) day 37 post-ESD, (c) day 51 post-ESD, and (d) 4 months post-ESD.
CRIGM2018-8046817.004.jpg
PMC6186326_01_CRIGM2018-8046817.004.jpg
fig4
Endoscopy performed on day 37 post-ESD (Figures 4(a) and 4(b)) showed granulation on the ulcer floor. Endoscopy performed on day 51 post-ESD (Figure 4(c)) showed that the ulcer shrunk and the false lumen disappeared and, on the basis of these findings, antibiotic treatment was terminated. Endoscopy at 4 months post-ESD (Figure 4(d)) showed complete resolution.