#new or missed finding?


New or missed finding?

A 57-year-old man underwent upper digestive endoscopy as a follow-up schedule for esophageal varices. The patient gave a history of hematemesis and melena four months ago. The patient underwent multiple endoscopies that revealed esophageal varices each time band ligation of these varices was done. The patient gives a history of chest problems; the patient is on a nebulizer every 12 hours and B2 stimulants. By examination, there is bilateral lower limb edema, abdominothoracic breathing, and bilateral chest rhonchi. Abdominal ultrasonography shows liver cirrhosis and moderate splenomegaly. The patient was previously treated for HCV virus three years ago. The current endoscopy revealed pan-gastropathy through the upper digestive system with a lesion in the lower esophagus. It looks like an ulcer or Barrett mucosa.

Question

Is this finding a missed lesion or a newly appeared one?

Keywords: #digestive endoscopy, chest rhonchi, #esophageal varices, lower esophageal lesion, #new lesion, #missed lesion, اد سالم يوسف#, مناظير الجهاز الهضمى والكبد#

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