An 84-year-old
man presented with recurrent hematemesis and melena was admitted to the endoscopy unit. The patient
gives a history of multiple upper GI endoscopies for injection of fundal varices and band ligation
of esophageal varices. The patient underwent upper digestive endoscopy. The scope revealed globular fundal lesions, three in number, and communicated to each other (video1).
What is
your provisional diagnosis?
To confirm
the diagnosis, the endoscopist used the tip of the closed biopsy forceps and
palpated these lesions, it revealed that these lesions are compressible (mostly
vascular) (video2).
What are
other investigations that can confirm this diagnosis and what are your differential
diagnoses?
When you
observe the fundus, you will notice tags of previously injected fundal varices,
so we proceed with the injection of the fundal varices with 5 ampoules of
amcrylate. After endoscopy, the patient was clinically stable and discharged from
the hospital and he was given another follow up for another session of fundal
varices injection(video3)
What are
your plans for the management of this patient?
fundal lesions
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