ERCP-related perforations may be difficult to diagnose by video endoscope and digital fluoroscope detection of retroperitoneal free air or contrast medium leakage can facilitate diagnosis.

A case of metastatic chondrosarcoma of the stomach in a 34-year-old female is reported. This patient had been diagnosed as having chondrosarcoma of the right knee and was operated on in 1984. Thereafter, there was repeated local recurrence and operations were performed on multiple metastases, including those of the lung, brain, ovary and spleen. In September, 1990, the patient was readmitted because of advanced anemia. Gastroendoscopy disclosed a firm elevated lesion with central irregular erosion. Histologically, there was cellular atypical cartilage with pleomorphic chondrocytes, which showed the same staining reactions as those in the primary lesion. Therefore this case was diagnosed as metastatic chondrosarcoma. This may be the first documentation of a case of gastric metastasis of chondrosarcoma.

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Congenital duodenal diaphragm (CDD) is a rare disease that is usually diagnosed in the neonatal period; however, it is sometimes diagnosed later in the adult period. A 39‐year‐old woman was referred to our hospital due to tarry stool and anemia. Emergent esophagogastroduodenoscopy (EGD) revealed an obstructing membranous structure with a small orifice in the second portion of the duodenum, together with dilatation of the bulbar part. The membranous structure was accompanied by a Dieulafoy‐like vessel on the backside, which was considered to have caused tarry stool and anemia. The Dieulafoy‐like vessel was successfully treated by endoscopic hemostasis. Based on the computed tomographic gastrography and barium duodenography findings, it was diagnosed as CDD. Later, endoscopic resection of the diaphragm was conducted by an endoscopic submucosal dissection (ESD)‐based procedure, with the use of an electrosurgical grasping‐type scissor forceps (ClutchCutter [CC]). There were no procedure‐related complications. The definite diagnosis of CDD was made based on the observation of typical structures in a pathological examination. This is the first case report of adult CDD that was successfully treated by endoscopic resection using ESD‐based techniques with a CC.