Many esophageal granular cell tumors (GCT) diagnosed incidentally during endoscopic examinations are less than 10 mm in diameter and can be treated endoscopically for histological examination of the entire lesion. However, it is difficult to remove them with sufficient surgical margins by conventional endoscopic methods because GCT, even if small in diameter, lie in the submucosal layer and lesions in the esophagus make it difficult to manipulate cutting devices. To overcome these drawbacks we tried using a ligating device that has recently been employed for endoscopic resection of early gastrointestinal carcinoma. Two patients diagnosed with GCT by biopsy, and with lesions confirmed to be in the submucosal layer by endoscopic ultrasonography, were treated easily and completely by this method without any complications. The tumors measured 5 × 5 mm and 8 × 6 mm. Endoscopic resection with the ligating device is thought to be the simplest and most effective endoscopic treatment for GCT.
Mediastinal abscesses caused by anastomotic leakage following esophago‐gastrostomy are associated with high morbidity and mortality. Surgical treatments are often difficult because of the presence of inflammation and adhesions. Percutaneous drainage techniques are limited due to the location of the esophagus. We attempted endoscopic transesophageal drainage in a 74‐year‐old male with a mediastinal abscess due to anastomotic leakage. This method reduced discharge into the cavity, and excellent drainage was obtained. It was less traumatic than techniques that employ flexible bronchofiberscopy. We were able to insert a guidewire through the anastomotic disruption site into the abscess cavity for observation. Endoscopic transesophageal drainage is therefore a safe and reliable technique for mediastinal abscesses caused by anastomotic leakage of esophago‐gastrostomy. (Dig Endosc 1996; 8: 236‐238)
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