PDF(Pubmed)
Abstract：
A 50-year-old female presented with symptomatic anemia and hematemesis due to a 3.3 cm gastric gastrointestinal stromal tumor (GIST), which was located in the fundus. Adequate endoscopic views were only achieved in the retroflexed position and attempts at hemostasis via endoscopic clips were unsuccessful. Subsequently, TC-325 hemostatic powder was sprayed on the bleeding lesion and given retroflexed positioning, the powder also coated the esophagogastroduodenoscopy (EGD) scope where it abutted the gastroesophageal junction (GEJ). Hemostasis was successful, but the scope was unable to be withdrawn due to adherence to the surrounding mucosa. With torque maneuvering and a moderate amount of withdrawal force, the scope was successfully freed. The patient was started on imatinib mesylate and did not experience further bleeding episodes. This case highlights the challenge of achieving hemostasis in a bleeding GIST, the beneficial role of hemostatic powder spray, and the need for caution when utilizing it in a retroflexed manner.
摘要：
一名50岁的女性因3.3厘米的胃胃肠道间质瘤（GIST）而出现有症状的贫血和呕血，位于眼底。仅在向后弯曲的位置获得了足够的内窥镜视图，并且通过内窥镜夹进行止血的尝试均未成功。随后，将TC-325止血粉喷洒在出血病灶上，并给予后弯曲定位，该粉末还覆盖了食管胃十二指肠镜检查（EGD）范围，并与胃食管交界处（GEJ）邻接。止血成功了,但由于粘附在周围粘膜上，无法撤除范围。具有扭矩操纵和适度的撤回力，范围已成功释放。患者开始使用甲磺酸伊马替尼，没有出现进一步的出血事件。这个案例突出了在出血的GIST中实现止血的挑战，止血粉喷雾的有益作用,以及以改进的方式使用它时需要谨慎。
