case_images: PMC11263129_01
case_images: Endoscopic evaluation before endoscopic submucosal dissection. (a) White-light imaging showing Barrett's esophagus (C8M9) without any visible lesions. (b) Narrow band imaging shows no visible lesions in Barrett's esophagus. (c) White-light imaging with the application of acetic acid showing no visible lesions. d. Narrow band imaging with applications of acetic acid showing no visible lesions.
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case_images: No macroscopic lesions were detected (Figure 1).
case_images: Material needed for the steroid lifting methods. (a) 1 mL syringe. (b) 18-gauge needle. (c) 5 mL syringe. (d) 10 mL syringe. (e) Gelofusine. (f) Saline solution. (g) Indigo carmine. (h) Triamcinolone acetonide. One milliliter of triamcinolone acetonide 40 mg/mL (h) is aspirated with an 18-gauge needle (b) using a 1 mL syringe (a) and then mixed with 3 mL of saline solution (f) in a 5 mL syringe (c). (referred to as syringe A). Nine milliliters of Gelofusine (e) are then mixed with 1 mL of the mixture from syringe A in a 10 mL syringe (referred to as syringe B). (d) This mixture is used as the lifting solution during the endoscopic submucosal dissection procedure.
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case_images: This mixture is used as the lifting solution during the ESD procedure (Figure 2).
case_images: The endoscopic submucosal dissection procedure. (a) The proximal side of the lesion with markings. (b) A clip-and-thread technique was used. Black arrow shows a whitish area corresponding to triamcinolone in the submucosal layer. (c) The mucosal defect after endoscopic mucosal dissection. Black arrow shows a whitish area corresponding to triamcinolone in the submucosal layer. (d) The resected specimen was 108 x 45 mm.
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case_images: Complete en-bloc resection was obtained without complications (Figure 3).
case_images: Follow-up endoscopy at 2 and 6 months follow up. (a, b) WLI showing fibrin-coated ulcer without any signs of stricture and recurrence of Barrett's esophagus at 2 months. (c, d) White-light imaging showing an endoscopic submucosal dissection scar without any signs of stricture or recurrence of the Barrett's esophagus at 6 months follow-up.
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case_images: Follow-up EGD showed no sign of stricture and no recurrence of the BE at 2, 6, 12, and 24 months. (Figure 4).