title: Endoscopic hemostasis with endoscopic mucosal resection and multiple synchronous early gastric cancers: a case report.
abstract: BACKGROUND
  Endoscopic hemostasis for severe upper gastrointestinal bleeding due to tumors, such as gastrointestinal stromal tumors and malignant lymphoma, is temporarily effective. However, permanent hemostasis is difficult in many cases because of diffuse bleeding.
  
  
  METHODS
  A 60-year-old Japanese woman was admitted to our hospital with hematemesis. Endoscopy revealed multiple gastric polyps and fresh blood in her stomach. One of the gastric polyps, which was associated with oozing bleeding, was found near the anterior wall of the lower gastric body. We initially applied hemostatic forceps and argon plasma coagulation over the tumor surface, but the bleeding persisted. After endoscopic mucosal resection, exposed vessels were seen at the base of the mucosal resection site with oozing bleeding. Coagulation of the bleeding vessels using hemostatic forceps allowed successful completion of the hemostatic procedure. Our patient also had eight synchronous gastric cancer lesions. Histological examination of the resected specimens showed various types of cancer.
  
  
  CONCLUSIONS
  This is a case report of gastric cancer associated with eight gastric cancer lesions, confirmed by histology, in which hemostasis was achieved through endoscopy.
authors.affiliation: Department of Gastroenterology and Neurology, Kagawa University, Faculty of Medicine, 1750-1 Ikenobe, Miki-cho, Kita-gun, Kagawa Prefecture 761-0793, Japan. joshin@med.kagawa-u.ac.jp.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Fujihara
authors.forename: Hirohito
authors.initials: H
authors.lastname: Mori
authors.forename: Noriko
authors.initials: N
authors.lastname: Nishiyama
authors.forename: Mitsuyoshi
authors.initials: M
authors.lastname: Kobayashi
authors.forename: Hideki
authors.initials: H
authors.lastname: Kobara
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Masaki