Prémio de Imagem Endoscópica 2022

The alternative becomes the solution

Pedro Antunes, Sofia Mendes, Tiago Leal, Bruno Gonçalves

Serviço de Gastrenterologia do Hospital de Braga

A 79-year-old man with a metastasized poorly cohesive gastric carcinoma of the antrum presented with symptomatic gastric outlet obstruction. Firstly, a transpyloric self-expanding metal stent was placed with clinical improvement. After 4 weeks, the symptoms recurred due to stent’s occlusion. Considering patient's good general condition and risk of short-term re-occlusion, an endoscopic ultrasound-guided gastroenterostomy was performed using a 15x10mm lumen-apposing metal stent. Eight weeks after the procedure, the patient remained asymptomatic with no food restrictions.