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false "LATM" => false ] "gratuito" => false "lecturas" => array:1 [ "total" => 0 ] "idiomaDefecto" => "en" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021057051830133X?idApp=UINPBA00004N" ] ] "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382418301548?idApp=UINPBA00004N" "url" => "/24443824/0000004100000008/v1_201810020619/S2444382418301548/v1_201810020619/en/main.assets" ] "en" => array:14 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Image of the month</span>" "titulo" => "Stenosing oesophageal carcinoma diagnosed endoscopically by gastrostomy" "tieneTextoCompleto" => true "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "512" "paginaFinal" => "513" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Marina Castellanos González, Carolina Delgado Martínez, Javier Pérez-Bedmar Delgado" "autores" => array:3 [ 0 => array:4 [ "nombre" => "Marina" "apellidos" => "Castellanos 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"mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 720 "Ancho" => 900 "Tamanyo" => 85101 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Retroflexion image of gastrostomy.</p>" ] ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall">Squamous cell carcinoma of the oesophagus accounts for 90% of oesophageal malignancies worldwide. The diagnosis is made by upper gastrointestinal endoscopy and is confirmed histologically from biopsy. Cases of endoscopy through gastrostomy are described in the literature for dilation of oesophageal stenoses.<a class="elsevierStyleCrossRefs" href="#bib0020"><span class="elsevierStyleSup">1–3</span></a> However, we found no cases of oesophageal biopsy through gastrostomy.</p><p id="par0010" class="elsevierStylePara elsevierViewall">Our patient was a 63-year-old male who had smoked since the age of 12 (cumulative amount of 70 pack-years). He had a planned upper gastrointestinal endoscopy for progressively worsening dysphagia over previous months. However, the investigation was incomplete, without visualizing underlying lesions, as it was impossible to cross the upper oesophageal sphincter.</p><p id="par0015" class="elsevierStylePara elsevierViewall">As an extension study, the patient went on to have fibre-optic laryngoscopy, detecting left hemi-laryngeal paralysis; cervical-thoracic-abdominal CT, identifying a cervical oesophageal mass occupying the entire lumen; and PET/CT, which showed the tumour to be in intimate contact with left thyroid lobe, without distant spread.</p><p id="par0020" class="elsevierStylePara elsevierViewall">In view of conventional upper gastrointestinal endoscopy being impossible and the difficult percutaneous approach with image-guided puncture, percutaneous gastrostomy was carried out under radiological technique and, once the fistula had matured, gastroscopy with ultrathin endoscope (EG16-K10) was performed through the gastrostomy (<a class="elsevierStyleCrossRef" href="#fig0005">Fig. 1</a>), accessing retrogradely from the cardia to the cervical oesophagus, where a large mass was found occupying the entire lumen. A biopsy was taken (<a class="elsevierStyleCrossRef" href="#fig0010">Fig. 2</a>).</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0025" class="elsevierStylePara elsevierViewall">The diagnosis of moderately differentiated and infiltrating squamous cell carcinoma was confirmed histologically. Treatment was started with radical chemoradiotherapy with curative intent.</p><p id="par0030" class="elsevierStylePara elsevierViewall">Stenosing neoplasms in the cervical oesophagus which prevent oral feeding and conventional endoscopic diagnosis may benefit from gastrostomy and retrograde access to the oesophagus. The technique has no serious complications, either immediate or late, and helps provide histological confirmation.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara" id="npar0005">Please cite this article as: Castellanos González M, Delgado Martínez C, Pérez-Bedmar Delgado J. Carcinoma esofágico estenosante diagnosticado endoscópicamente a través de ostomía gástrica. Gastroenterol Hepatol. 2018;41:512–513.</p>" ] ] "multimedia" => array:2 [ 0 => array:7 [ "identificador" => "fig0005" "etiqueta" => "Figure 1" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr1.jpeg" "Alto" => 720 "Ancho" => 900 "Tamanyo" => 85101 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Retroflexion image of gastrostomy.</p>" ] ] 1 => array:7 [ "identificador" => "fig0010" "etiqueta" => "Figure 2" "tipo" => "MULTIMEDIAFIGURA" "mostrarFloat" => true "mostrarDisplay" => false "figura" => array:1 [ 0 => array:4 [ "imagen" => "gr2.jpeg" "Alto" => 736 "Ancho" => 900 "Tamanyo" => 45866 ] ] "descripcion" => array:1 [ "en" => "<p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Distal view of stenosing neoplasm in the cervical oesophagus, seen by retrograde endoscopy (through gastrostomy).</p>" ] ] ] "bibliografia" => array:2 [ "titulo" => "References" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0015" "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib0020" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Retrograde endoscopic-assisted esophageal dilation" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. 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Jun" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1007/s00464-013-3215-x" "Revista" => array:6 [ "tituloSerie" => "Surg Endosc" "fecha" => "2014" "volumen" => "28" "paginaInicial" => "603" "paginaFinal" => "606" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/24196544" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "en" "url" => "/24443824/0000004100000008/v1_201810020619/S2444382418301585/v1_201810020619/en/main.assets" "Apartado" => array:4 [ "identificador" => "75461" "tipo" => "SECCION" "en" => array:2 [ "titulo" => "Images of the month" "idiomaDefecto" => true ] "idiomaDefecto" => "en" ] "PDF" => "https://static.elsevier.es/multimedia/24443824/0000004100000008/v1_201810020619/S2444382418301585/v1_201810020619/en/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S2444382418301585?idApp=UINPBA00004N" ]
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