Gastric Polyps, El Salvador Atlas of Gastrointestinal VideoEndoscopy. A Large Database of Images and Video Clips with Cases Reported.
El Salvador Atlas of Gastrointestinal VideoEndoscopy

 
This it is the case of a 62 year-old male with two hyperplasic polyps and one tiny ulcerated lesion at the pre-piloric antrum of the lesser curvature. One of the polyps was located in the gastroesofagic junction, and the other in the antrum. By biopsies hyperplasic nature was confirmed. We decided to use the strangulate method with rubber bands instead of the traditional endoscopic polypectomy.

Video Endoscopic Sequence 1 of 14.

 This is the case of a 62 year-old male with two
 hyperplasic polyps and one tiny ulcerated lesion at the
 pre-piloric antrum of the lesser curvature. One of the
 polyps was located in the gastroesofagic junction, and the
 other in the antrum. By biopsies hyperplasic nature was
 confirmed.

 We decided to use the strangulate method with rubber
 bands instead of the traditional endoscopic polypectomy.

 
Contrast Indigo Carmine Chromoscopy.

Video Endoscopic Sequence 2 of 14.

 Contrast Indigo Carmine Chromoscopy.
In this image as well as the video is observed the polyp of the gastroesofagic junction.

Video Endoscopic Sequence 3 of 14.

 In this image as well as the video is observed the polyp
 of the gastroesofagic junction.

 
The polyp at the antrum.

Video Endoscopic Sequence 4 of 14.

The polyp at the antrum.

 
The therapeutic treatment with the rubber bands is initiated. Endoscopic ligation is highly effective in obliterating polyps. The use of a multibander device for endoscopic polypectomy is technically feasible and safe, and its use results in more rapid ablation of gastric polyps.

Video Endoscopic Sequence 5 of 14.

 The therapeutic treatment with the rubber bands
 is initiated.

 Endoscopic ligation is highly effective in obliterating polyps.
 The use of a multibander device for endoscopic
 polypectomy is technically feasible and safe, and its use
 results in more rapid ablation of gastric polyps.

 
Two bands have been placed at the stalk. Endoscopic band ligation for bleeding small-bowel vascular lesions has been reported as safe and efficacious based on small case series. There have been several other published case reports of band ligators used for bleeding lesions, usually Dieulafoy's lesions, in the stomach, the proximal small bowel, and the colon. In addition, this method has been used for postpolypectomy bleeding stalks.

Video Endoscopic Sequence 6 of 14.

Two rubber bands have been placed at the stalk.

 Endoscopic band ligation for bleeding small-bowel vascular
 lesions has been reported as safe and efficacious based on
 small case series. There have been several other published
 case reports of band ligators used for bleeding lesions,
 usually Dieulafoy's lesions, in the stomach, the proximal
 small bowel, and the colon. In addition, this method has
 been used for postpolypectomy bleeding stalks.

Other two bands were placed to the polyp of the gastroesofagic junction.

Video Endoscopic Sequence 7 of 14.

 Other two bands were placed to the polyp of the
 gastroesofagic junction.

 
Strangulating the mucosa of the ulcerated lesion of the antrum.

Video Endoscopic Sequence 8 of 14.

 Strangulating the mucosa of the ulcerated lesion of
 the antrum.

 
In the image and the video are observed two polyps that have been ligated. Historically, in the pre-endoscopic era, the patients with polyps of upper digestive tract were treated with surgical resection; the patients with low risk did not operate unless a change in size of the polyp noticed or malignant degeneration in the radiological studies were suspected. In 1968, the first report of a successful endoscopic gastric polypectomy was published and, as of this moment, the therapeutic approach to these injuries changed radically.

Video Endoscopic Sequence 9 of 14.

 In the image and the video are observed two polyps that
 have been ligated.

 Historically, in the pre-endoscopic era, the patients with
 polyps of upper digestive tract were treated with surgical
 resection; the patients with low risk did not operate unless
 a change in size of the polyp noticed or malignant
 degeneration in the radiological studies were suspected.

 In 1968, the first report of a successful endoscopic gastric
 polypectomy was published and, as of this moment, the
 therapeutic approach to these injuries changed radically.
The polyp of the cardia with two bands.

Video Endoscopic Sequence 10 of 14.

The polyp of the cardia with two bands.

 
Another image and video of the strangled polyps.

Video Endoscopic Sequence 11 of 14.

 Another image and video of the strangled polyps.

 
On the following day, approximately 30 hours later, a new endoscopy was made, observing the effectiveness of this method.

Video Endoscopic Sequence 12 of 14.

 On the following day, approximately 30 hours later, a new
 endoscopy was made, observing the effectiveness of this
 method.

Rest of medicines are observed adhered.

 
The necrosis caused by the bands is demonstrated.

Video Endoscopic Sequence 13 of 14.

The necrosis caused by the bands is demonstrated.

 
In the case of the polyp of the cardia the polyp in almost its totality has been only given off, observing only the two bands in stalk.

Video Endoscopic Sequence 14 of 14.

 In the case of the polyp of the cardia the polyp in almost its
 totality has been only given off, observing only the two
 bands in stalk.

 
Hyperplastic Gastric Polyposis.

Video Endoscopic Sequence 1 of 6.

Hyperplastic Gastric Polyposis.

 


 
 For more endoscopic details download the video clips by
 clicking on the endoscopic image.
 All endoscopic images shown in this Atlas contain a video
 clip. We recommend seeing the video clips in full screen
 mode.

Many hyperplastic polyps are found incidentally on gastroscopy. Physical findings are not specific. Hyperplastic polyps are by far the most common histologic type, and they can vary in location, number, and size. Most are less than 2 cm. Although these polyps harbor no malignancy, they may be accompanied by atrophic gastritis, which predisposes the nonpolypoid mucosa to malignant transformation.

Video Endoscopic Sequence 2 of 6.

 Many hyperplastic polyps are found incidentally on
 gastroscopy. Physical findings are not specific.
 Hyperplastic polyps are by far the most common histologic
 type, and they can vary in location, number, and size. Most
 are less than 2 cm. Although these polyps harbor no
 malignancy, they may be accompanied by atrophic gastritis,
 which predisposes the nonpolypoid mucosa to malignant
 transformation.
Hyperplastic polyps are the most frequently encountered subtype of gastric polypoid lesions. They are usually associated with chronic gastritis or H pylori gastritis. They may harbour adenomatous changes or dysplastic foci. Therefore, endoscopic polypectomy seems as a safe and fast procedure for both diagnosis and treatment of gastric polypoid lesions at the same session. In addition, edematous mucosa may appear misleadingly as a polypoid lesion in some instances and it can be ruled out only by histopathologic examination.

Video Endoscopic Sequence 3 of 6.

 Hyperplastic polyps are the most frequently encountered
 subtype of gastric polypoid lesions. They are usually
 associated with chronic gastritis or H pylori gastritis.
 They may harbour adenomatous changes or dysplastic foci.
 Therefore, endoscopic polypectomy seems as a safe and
 fast procedure for both diagnosis and treatment of gastric
 polypoid lesions at the same session.
 In addition, edematous mucosa may appear misleadingly
 as a polypoid lesion in some instances and it can be ruled
 out only by histopathologic examination.

 
Numerous fundic gland polyps in the gastric corpus.

Video Endoscopic Sequence 4 of 6.

Numerous fundic gland polyps in the gastric corpus.

 

 
Chromoendoscopy with indigo carmin.

Video Endoscopic Sequence 5 of 6.

Chromoendoscopy with indigo carmin.
More images and video clips of this case of multiple gastric polyposis.

Video Endoscopic Sequence 6 of 6.

 More images and video clips of this case of multiple
 gastric polyposis.
This 30 year old female presented with a large mass one year previously, this lesion was small, we wanted to snare it but patient did not show up, at that time the biopsies reveled a hyperplastic polyp.

Video Endoscopic Sequence 1 of 8.

Hyperplastic Polyp.

 This 30 year old female, presented with a large mass.
 One year previously, this lesion was small, we wanted to
 snare it but patient did not show up, at that time the
 biopsies reveled a hyperplastic polyp.
 Argon Plasma Coagulator was used as a therapeutical
 approach.
Chromoendoscopy with indigo carmin.

Video Endoscopic Sequence 2 of 8.

Chromoendoscopy with indigo carmin.
The image and the video clip display the extension of the large mass.

Video Endoscopic Sequence 3 of 8.

 The image and the video clip display the extension of
 the large mass.
Three months after a follow up endoscopy was performed. Status post coagulation with argon plasma coagulator is observed. This mass has been diminished in size.

Video Endoscopic Sequence 4 of 8.

Three months after a follow up endoscopy was performed.

 Status post coagulation with argon plasma coagulator is
 observed. This mass has been diminished in size.

 
Another image and video clip.

Video Endoscopic Sequence 5 of 8.

Another image and video clip.
A new treatment with argon plasma coagulator is being performed.

Video Endoscopic Sequence 6 of 8.

 A new treatment with argon plasma coagulator is being
 performed.
This image and the video clip show the coagulation with argon plasma coagulator.

Video Endoscopic Sequence 7 of 8.

 This image and the video clip show the coagulation with
 argon plasma coagulator.
Appearance post APC.

Video Endoscopic Sequence 8 of 8.

Appearance post APC.
Endoscopy Polypectomy of Adenomatous Gastric Polyp. Symptomatic gastric polyps should be removed preferentially when they are detected at the initial diagnostic endoscopy Polypectomy not only provides tissue to determine the exact histopathologic type of the polyp, but also achieves radical treatment. Gastric polyps may be single or multiple, and pedunculated or sessile in form. It is rare for a gastric polyp to grow to more that a few centimetres in diameter. Generally, they are asymptomatic but can produce haemorrhage, abdominal pain or obstruction of the pyloric canal. Usually a gastric polyp is an incidental findings on radiological or endoscopic investigation. They probably account for a very small proportion of gastric carcinomas but should nevertheless receive regular endoscopic follow-up. Treatment is via endoscopic excision biopsy. Submucosal polyps, although not necessarily malignant.

Endoscopy Polypectomy of Adenomatous Gastric Polyp.

 Symptomatic gastric polyps should be removed preferentially
 when they are detected at the initial diagnostic endoscopy
 Polypectomy not only provides tissue to determine the exact
 histopathologic type of the polyp, but also achieves radical
 treatment.

 Gastric polyps may be single or multiple, and pedunculated or
 sessile in form. It is rare for a gastric polyp to grow to more that
 a few centimetres in diameter. Generally, they are asymptomatic
 but can produce haemorrhage, abdominal pain or obstruction of
 the pyloric canal. Usually a gastric polyp is an incidental findings
 on radiological or endoscopic investigation.
 They probably account for a very small proportion of gastric
 carcinomas but should nevertheless receive regular endoscopic
 follow-up.

 Treatment is via endoscopic excision biopsy. Submucosal polyps,
 although not necessarily malignant, cannot be resected
 endoscopically. However, endoscopic ultrasound may be a
 means of surveillance of these lesions.
This is the case of a 57 year old female with a large ulcerated hyperplasic polyp of the gastric cardias, presented with hematemesis and melena.

Video Endoscopic Sequence 1 of 4.

 This is the case of a 57 year old female with a large
 ulcerated hyperplasic polyp of the gastric cardias,
 presented with hematemesis and melena.

This image and the video clip display the stalked polyp. Hyperplastic foveolar glands and inflamed, edematous lamina propria are the hallmarks of this lesion. Surface erosion is common and reactive inflammatory and regenerative epithelial changes are frequent.

Video Endoscopic Sequence 2 of 4.

This image and the video clip display the stalked polyp.

 Hyperplastic foveolar glands and inflamed, edematous
 lamina propria are the hallmarks of this lesion. Surface
 erosion is common and reactive inflammatory and
 regenerative epithelial changes are frequent.
GastricHyperp3

Video Endoscopic Sequence 3 of 4.

An endoscopy polypectomy is observed.
The pedicle is being cauterized.

Video Endoscopic Sequence 4 of 4.

 

The pedicle is being cauterized.
An endoscopy polypectomy is observed. A 91 year-old female that six weeks previously had an giant ulcer, in this occasion an subsequent endoscopy was performed, in the video clip the scar of the ulcer is observed .

Video Endoscopic Sequence 1 of 7.

Gastric Polyp.

 A 91 year-old female that six weeks previously had an
 giant ulcer, in this occasion an subsequent endoscopy was
 performed, in the video clip the scar of the ulcer is
 observed
 
 See the video sequence of that giant ulcer.
 
The gastric polyps observed using a magnifying endoscope.

Video Endoscopic Sequence 2 of 7.

 The gastric polyps observed using a magnifying endoscope.
More images and video clips of magnifying endoscopy.

Video Endoscopic Sequence 3 of 7.

 More images and video clips of magnifying endoscopy.
Magnifying endoscopy with Chromoendoscopy.

Video Endoscopic Sequence 4 of 7.

 More images and video clips of magnifying endoscopy.
Magnifying endoscopy and with methylene blue. Chromoendoscopy involves the topical application of stains or pigments to improve tissue localization, characterization, or diagnosis during endoscopy.

Video Endoscopic Sequence 5 of 7.

 Magnifying endoscopy and with methylene blue.
 Chromoendoscopy involves the topical application of stains
 or pigments to improve tissue localization, characterization,
 or diagnosis during endoscopy.
 
 
 
The image and the video display the catheter spraying the methylene blue. Chromoendoscopy. Chromoendoscopy has been applied in a variety of clinical settings and throughout all gastrointestinal tract segments that are accessible to the endoscope. Interest has been renewed in recent years in part because of the development of new technologies such as endoscopic mucosal resection and photodynamic therapy, which require precise visual tissue characterization.

Video Endoscopic Sequence 6 of 7.

 The image and the video display the catheter spraying the
 methylene blue. Chromoendoscopy.
 Chromoendoscopy has been applied in a variety of clinical
 settings and throughout all gastrointestinal tract segments
 that are accessible to the endoscope. Interest has been
 renewed in recent years in part because of the development
 of new technologies such as endoscopic mucosal resection
 and photodynamic therapy, which require precise visual
 tissue characterization.
Magnifying endoscopy with Chromoendoscopy.

Video Endoscopic Sequence 7 of 7.

 Another image and video clip of the chromoendoscopy.


 

 
Hyperplastic Polyp of the Gastric Cardias. These are the most common epithelial polyps of the stomach and are found throughout the stomach, ranging in size from a few millimeters to centimeters. Hyperplastic polyps have been reported in association with various types of chronic gastritis, particularly autoimmune gastritis, Helicobacter pylori gastritis, and the post antrectomy stomach. Long-term use of proton pump inhibitors may be associated with the presence of small gastric fundic gland polyps and hyperplastic polyps.

Hyperplastic Polyp of the Gastric Cardias.

 These are the most common epithelial polyps of the
 stomach and are found throughout the stomach, ranging in
 size from a few millimeters to centimeters. Hyperplastic
 polyps have been reported in association with various
 types of chronic gastritis, particularly autoimmune
 gastritis, Helicobacter pylori gastritis, and the
 post antrectomy stomach. Long-term use of proton pump
 inhibitors may be associated with the presence of small
 gastric fundic gland polyps and hyperplastic polyps.
 
 
Multiple polyps of the body and gastric fundus.

 Multiple polyps of the body and gastric fundus.

 
Tiny flat adenoma.

Video Endoscopic Sequence 1 of 2.

Tiny flat adenoma.
Tiny flat adenoma. Now seen with magnification.

Video Endoscopic Sequence 2 of 2.

Tiny flat adenoma.

Now seen with magnification.
Hyperplaginous polyp that caused hematemesis.

 Hyperplaginous polyp that caused hematemesis.

 
     
Gastric polyp that was removed with the diathermy snare.

 Gastric polyp that was removed with the diathermy snare.
 (polypectomy).

Antrum Polyps and gastric carcinoma. There are several gastric polyps, the video clip display a gastric carcinoma of the corpus. Gastric polyps are primarily of interest because of their potential relationship to gastric carcinoma. They are almost always asyntomatic and are usually discovered as an incidental finding at an endoscopic examination .

Antrum Polyps and Gastric Adenocarcinoma.

 There are several gastric polyps, the video clip display a
 gastric carcinoma of the corpus.
 Gastric polyps are primarily of interest because of their
 potential relationship to gastric carcinoma. They are almost
 always asyntomatic and are usually discovered as an
 incidental finding at an endoscopic examination.
 
  
Gastric polyp at the cardias. The video clip displays a gastric carcinoma at the corpus and fundus a polyp is observed.

Gastric polyp at the cardias.

 The video clip displays a gastric carcinoma at the corpus
 and fundus a polyp is observed.
     
 
 
Multiple gastric polyps. This sequence displays multiple gastric polyps some of them are removed with the diathermy snare method. (polypectomy).

Video Endoscopic Sequence 1 of 3.

 This sequence displays multiple gastric polyps some of
 them are removed with the diathermy snare method.
                 (polypectomy). 

The image and the video display the diathermy snare. (polypectomy device).

Video Endoscopic Sequence 2 of 3.

 The image and the video display the diathermy snare.
 (polypectomy device).

Polypectomy of a gastric polyps is carry out.

Video Endoscopic Sequence 3 of 3.

 Polypectomy of a gastric polyps is carry out.
Hyperplasic polyp at the pre-pyloric antrum. The video clip displays the peristaltism, two ulcers and the biopsies.

Video Endoscopic Sequence 1 of 3.

 Hyperplasic polyp at the pre-pyloric antrum.
 The video clip displays the peristaltism, two ulcers
 and the biopsies.