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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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