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Esophageal mucosal tear occurred during scope insertion in a 71-year-old male patient who previously underwent endoscopic retrograde cholangiopancreatography (ERCP) several times without any complications. The mucosal tear was successfully sealed with endoclips using a forward-viewing scope. However, this mishap leads to the incidental discovery of both esophageal cancer and early gastric cancer. Duodenoscope has inherent limitation in observing the gastrointestinal tract, especially the esophagus, and may miss clinically significant lesions. Therefore, in addition to applying sufficient lubricant to the scope tip and considering the possibility of anatomical variation to prevent mucosal injury or perforation, performing upper endoscopy during ERCP should be considered in a certain patient population, albeit the utility of and the population benefiting from it remains to be proven by a large-scale study. Korean J Pancreas Biliary Tract 2018;23(2):76-81

the korean journal of pancreas and biliary tract/daehan chwedamdo haghoeji

Synchronous Esophageal and Gastric Cancer Detected by Iatrogenic Esophageal Mucosal Injury Incurred During Endoscopic Retrograde Cholangiopancreatography