A case of submucosal tumor of the fornix prolapsed into duodenal valve and treated with detachable snare for active bleeding

Abstract

A-83-year old female had epigastral discomfort since middle of May 2003. She visited our hospital becase of hematemesis on 29th May. Lavoratory data showed decreased hemoglobin. Emergency endoscopic examination revealed active bleeding from giant submucosal tumor (SMT) of the fornix and treated with injection of 1/5,000 Epinephrine. On Next day, SMT prolapsed into duodenal valve was revealed in the endoscopic examination and was returned to stomach from duodenal valve by endoscopic technique. However active re-bleeding from SMT was noted and treatment for bleeding was performed by hanging detachable snare based on the SMT. Suddenly bleeding was stopped and SMT was getting degenerated by necrotic change after treatment, and so histological diagnosis of SMT was failed out. Three months after treatment, endoscopic examination showed ulcer scar after endoscopic treatment for SMT and endoscopic ultrasonography was could not disclosed evidence of SMT.