Diagnosis of submucosal tumors by injecting a water soluble contrast medium: judgement of tumor developing pattern and endoscopic lumpectomy.

With the remarkable increases in the number of cases of endoscopical removal of submucosal tumors spurred by the application of high-frequency current, it has become more and more important to apply beforehand some reliable methods like ours to differentiate between tumors and other tumescent lesions due to extra-gastric pressure similar in configuration to tumors and also to confirm the development patterns of tumors either intra-gastric or extra-gastric. Such preparatory arrangements seem indispensable to minimize the risk of perforation incidental to the endoscopical treatment of tumors. To cope with another danger of major bleeding following tumor resection, securing on hand an effective hemostatic is indispensable as well. In our care of the patients after their undergoing endoscopical lumpectomies, we usually subject them to quiet rest and fasting for two or three days; then when they are to resume a regular diet, we endoscopically examine them before and after each meal to confirm the presence or absence of bleeding. In 12 subjects of this series treated with our routine and finally with lumpectomies for gastric submucosal tumors, no serious adverse reactions developed.