FOR HOW LONG CAN AN ENDOCLİP REMAİN İN PLACE WİTHOUT DİSLODGED?

U. AVCIOĞLU, SH. OLMEZ, S. SAYAR, B. KAYHAN, E. OZASLAN, E. ALTIPARMAK

Ankara Numune Education and Research Hospital, Ankara, TURKEY

Introductıon: Endoscopic clips are widely used in the treatment of upper and lower gastrointestinal system bleeding, treatment of perforations, and marking of lesions before surgery or radiotherapy. It has been reported that endoclips used in literature are removed from the tissue and dislodged without any complications in 1-5 weeks, 9.4 days on average depending on the type of the endoclip. However, there are two cases in literature where the clips were not dislodged after 2 and 1 years after treatment respectively. We hereby present a case in which the bleeding was controlled after an upper gastrointestinal system bleeding which resulted from Mallory-Weiss syndrome and endoclips were still in place when sought with gastroesophageal reflux symptoms.

Case: A 37 year-old male patient was consuming alcohol on a regular basis for 6 years. Sclerotheraphy and 3 endoclips (Olympus EZ Standard Clip, Tokyo, Japan) were applied to the patient who had been diagnosed with upper gastrointestinal system bleeding resulting from Mallory-Weiss syndrome 21 months before. The patient in hospitalition period 6 units of erythrocyte suspension was given. After the discharged he stil continueing of moderate level alcohol consumption. He admitted to our clinic with syptoms of; burning, nausea and sometimes solid food sticking in the back of his chest. In the laboratory examinations carried out the results were these: Hb 12.9 gr/dl, ALT:41 mU/mL, GGT: 230 U/L, TBil.1.3 mg/dl. In the upper gastrointestinal system endoscopy, 2 endoclips whose ends were partially buried in the mucosa were monitored near the cardioesophageal junction. Although the clips were tried to be removed endoscopically, this was not possible as bleeding occurred in the process.

Conclusıon: Information related to the endoclips which are not dislodged is limited in literature. Some symptoms of patients who were treated with endoclips may be due to the endoclips which are not dislodged. At the same time, the presence of endoclips is a contraindicated situation for magnetic resonance imaging. Therefore, the presence of any endoclips must be inquired before MR.

Date: 2014-12-28; view: 3733