The 29-year-old female patient was hospitalized many times due to hypoglycemia, sometimes the blood sugar was only 34 mg/dL. Initial blood biochemical tests did not detect obvious abnormalities. When performing MRI, doctors discovered many tumors in the head, body and pancreatic tail.
Continuing the endoscopic ultrasound examination, doctors discovered many small tumors, about 9-10 mm in size, with clear boundaries and increased vascular proliferation around. The patient was sampled tissue with a small needle for testing. The results determined that this was a pancreatic insulin-secreting neuroendocrine tumor.
After consultation, doctors decided to treat the tumor by high-frequency radiotherapy (RFA) under the guidance of endoscopic ultrasound. Because the patient had many tumors in different locations, the team divided it into two treatment sessions, one week apart.
After treatment, the patient no longer had symptoms of hypoglycemia and returned to normal activities. When re-examined, blood sugar was at about 70 mg/dL. CT images showed that the tumor in the pancreatic head had signs of calcification, and the remaining lesions were in the process of recovery.
According to doctors, RFA under endoscopic ultrasound guidance has the advantage of helping doctors directly observe the location of the tumor and the path of the needle during intervention. In appropriate cases, this method can help patients avoid major surgery and can be performed again when necessary.
At the scientific conference with the theme "Updating gastrointestinal endoscopy and intervention" held at Hong Bang International University Hospital on September 12, MSc. BSCKII Trinh Pham My Le, Deputy Head of the Department of Endoscopy, Cho Ray Hospital, Ho Chi Minh City, said that endoscopic ultrasound appeared in the 1980s, initially mainly used to observe lesions deep inside the digestive tract and abdominal cavity. In recent years, this technique has made many advances, from diagnosis to supportive treatment.
In diagnosis, endoscopic ultrasound is now integrated with many technologies to help assess lesions more accurately, and at the same time support tissue sampling for testing. New generations of biopsy needles can take tissue samples of sufficient quality to perform in-depth tests, contributing to identifying diseases and choosing appropriate treatment methods for each patient.
A notable step forward is that endoscopic ultrasound can guide drainage of plague sites, bile ducts or create new pathways in some cases of gastrointestinal obstruction. Thanks to that, some patients can avoid complex surgical interventions when appropriately indicated.
In addition, endoscopic ultrasound is being expanded in the field of liver and gallbladder, such as portal venous pressure measurement, liver biopsy and treatment of some cases of gastric varicose veins. The advantage is that it can access lesions through the digestive tract, limit tissue damage and help patients recover faster in appropriate cases, contributing to reducing the need for surgery in some diseases.
