Curbside Consultation in Endoscopy: 49 Clinical Questions, Second Edition

Joseph Leung, MD; Simon Lo, MD

Question 46: A 35-Year-Old Mechanic Is Complaining Of New Onset Epigastric Pain After Taking Motrin. Egd Shows Mild, Nonerosive Antral Gastritis, And A 1-Cm Submucosal Mass In The Proximal Antrum. Biopsies Showed Chronic Inflammation. What Should I Do? (continued)

Laith H. Jamil, MD

When you see a gastric submucosal/subepithelial mass/bulge on endoscopy, you have to wonder whether it is arising from the gastrointestinal wall (intramural) or whether this is an extramural lesion causing compression. Unfortunately, endoscopy alone cannot distinguish between them adequately.1,2 If this patient had cross sectional imaging that showed normal structures, it does not rule out the fact that this lesion could still be secondary to extrinsic compression by a normal structure, or that it’s a true lesion that will not be picked up by imaging, especially small (< 2 cm)…
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