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Endoscopic therapy for upper gastrointestinal bleeding: less is more?
  1. Baldwin P M Yeung1,
  2. Carol Craig2,
  3. John Morris3,
  4. Andrew Christie4,
  5. Ram Kasthuri4,
  6. Wesley Stuart5,
  7. Adrian J Stanley3
  1. 1 Department of Surgery, Seng Kang Health, Singapore, Singapore
  2. 2 Department of Surgery, Glasgow Royal Infirmary, Glasgow, UK
  3. 3 Department of Gastroenterology, Glasgow Royal Infirmary, Glasgow, UK
  4. 4 Department of Interventional Radiology, Queen Elizabeth University Hospital, Glasgow, UK
  5. 5 Department of Vascular Surgery, Queen Elizabeth University Hospital, Glasgow, UK
  1. Correspondence to Dr Baldwin P M Yeung, Department of Surgery, Sengkang Health, Singapore 159964, Singapore; baldwin.yeung.p.m{at}singhealth.com.sg

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Case

An elderly patient with a known symptomatic oesophageal radiation stricture had endoscopic dilatation to 15 mm to good effect. The stricture developed as a consequence of radical chemoradiotherapy for unresectable lung cancer more than 7 years ago. Repeat biopsies did not reveal dysplasia or malignancy.

Four months later, a CT was performed as part of lung cancer follow-up. It did not show evidence of cancer recurrence; however, a small asymptomatic mid-oesophageal perforation was identified. This was managed conservatively by nasojejunal feeding. Repeat CT with oral contrast showed no evidence of contrast extravasation. After multidisciplinary discussion, fibrin sealant …

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Footnotes

  • Contributors BPMY and AJS conceived of the study. All authors contributed to the clinical management of the patient. All authors contributed to refinement of the case report and approved the final manuscript.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.