"Black eye lesion”: A black hole within a resected lesion
Maria José Temido1; Elisa Gravito-Soares1,2; Pedro Amaro1; Pedro Figueiredo1,2
1 Serviço de Gastrenterologia do Centro Hospitalar e Universitário de Coimbra; 2 Faculdade de Medicina da Universidade de Coimbra
DESCRIPTION
A case of a 73-year-old man previously diagnosed with a periappendicular lesion. The lesion, with adenomatous non-invasive appearance, circumferentially involved the periappendicular area, with uncertain penetration into the lumen (figure 1).
Figure 1
After underwater-EMR, the resection fragment (figure 2A), revealed a central hole, the appendiceal lumen. This “black hole” is a metaphor of the unknown involvement of the lumen, which was subsequently unveiled by forceps traction (figure 2B).
Figure 2A and 2B
As completion conventional resection was no longer possible, a successful endoscopic full-thickness resection (FTRD®Ovesco) was then performed (figure 3). The patient underwent clinical, analytical and ultrasonographic surveillance. No signs of appendicitis/other complications were detected.
Figure 3