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Slide 1: 

Endoscopy • "Viewing from the inside " • Not only observing but also defining and interpreting

Endoscopy : 

Endoscopy 1. Insertion and observation 2. Findings and lesions 3. Missing the lesions? 4. Biopsy 5. Altered anatomy

Slide 3: 

Insertion

Slide 5: 

Observation of esophagus

Slide 7: 

Observation of angle

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Observation of angle

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Superior duodenal angle

Slide 10: 

Splenic compression

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Endoscopy 1. Insertion and observation 2. Findings and lesions 3. Missing the lesions? 4. Biopsy 5. Altered anatomy

Slide 17: 

Hiatal hernia with esophagitis

Slide 18: 

Esophageal lesions

Slide 19: 

Esophagitis

Slide 20: 

Esophageal cancer

Slide 21: 

Lineal gastritis

Slide 22: 

AGML

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Erosion vs Tumor

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Benign ulcer

Slide 25: 

Malignant ulcer

Slide 26: 

Dye spray

Slide 27: 

Benign ulcer, healing stage

Slide 28: 

Concept of the “malignant cycle” in early gastric cancer.

Slide 29: 

Malignant ulcer, mimicking benign

Slide 30: 

EGC, protruded type

Slide 31: 

EGC (type IIc)

Slide 32: 

EGC (type IIc + III)

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PM cancer

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Submucosal tumor

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Endoscopy 1. Insertion and observation 2. Findings and lesions 3. Missing the lesions? 4. Biopsy 5. Altered anatomy

Slide 36: 

Minute cancer

Slide 37: 

Minute cancer

Slide 38: 

Thickened gastric fold

Slide 39: 

Stomach cancer, Borrman IV

Scirrhous Carcinoma (Borrmann IV) : 

Scirrhous Carcinoma (Borrmann IV) 1. Difficult early detection (5-16%) 2. Missing the lesion even in advanced stage 3. Initial endoscopic biopsy, malignancy less than 70% 4. Poorly differentiated cell type 5. Diverse course, young female (IIc without fold change, giant fold) 6. Suspicion, repeated biopsy, barium study, and short term follow up

Slide 42: 

Suction (Borrman IV)

Scirrhous Type Cancer : 

Scirrhous Type Cancer 1. Suspicion 2. Biopsy (multiple, boring, strip) 3. Air inflation and deflation 4. UGI 5. Short-term follow-up

Stomach Cancer Involving Gastroesophageal Junction : 

Stomach Cancer Involving Gastroesophageal Junction 1. Squamous cell cancer extended from distal esophagus 2. Adenocarcinoma of Barrett's esophagus 3. Adenocarcinoma of cardia (<2 cm from GE jucntion) 4. Adenocarcinoma extended from proximal stomach

Slide 49: 

Cardia cancer

Slide 50: 

Cardia lesion

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Cardia cancer

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Endoscopy 1. Insertion and observation 2. Findings and lesions 3. Missing the lesions? 4. Biopsy 5. Altered anatomy

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Biopsy

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Biopsy

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Biopsy, up slope

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Boring biopsy (Borrman IV cancer)

Slide 57: 

Biopsy with Cap

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Biopsy

Slide 59: 

Endoscopy 1. Insertion and observation 2. Findings and lesions 3. Missing the lesions? 4. Biopsy 5. Altered anatomy

Slide 60: 

Post op. anatomy

5 "E" of Endoscopy : 

5 "E" of Endoscopy 1. Educated person 2. Exact diagnosis 3. Elegant maneuver 4. Extraordinary idea 5. Extended kindness to patient