Peroral endoscopic myotomy (POEM) - Identifying Bleeding point with RDI Mode1

2024-1-26 18:00

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Dr. D Nageshwar Reddy, AIG Hospitals, Hyderabad, India There was an inadvertent injury to the blood vessel, leading to bleeding. White-light imaging showed pooling of blood without clear delineation of the bleeding point. Because of the differential absorption of amber light, the bleeding point was better identified with RDI. Identification of the bleeding point is difficult with an oozing type of bleed under white-light imaging. The bleeding point appears a deeper yellow than the surrounding area under RDI because amber light absorption is greater at the bleeding point, which has a higher hemoglobin concentration than the surrounding area where blood has been diluted. Scope : GIF-EZ1500 Case : Peroral endoscopic myotomy (POEM) Organ : Esophagus Patient Information : M, 40 Medical History : 1-year history of difficulty in swallowing liquids and solids. His Eckhart’s score was 6 of 12. EGD showed dilated esophagus with liquid stasis and mild resistance noted across the gastroesophageal junction. Esophageal manometry showed elevated integrated relaxation pressure with panesophageal pressurization (achalasia cardia type II)

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