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Pyogenic spondylitis following endoscopic submucosal dissection for early gastric cancer
  1. Shun Takai1,
  2. Gota Sudo1,2,
  3. Atsushi Yawata1 and
  4. Hiroshi Nakase2
  1. 1Department of Gastroenterology and Hepatology, Hakodate Goryoukaku Hospital, Hakodate, Hokkaido, Japan
  2. 2Department of Gastroenterology and Hepatology, Sapporo Medical University School of Medicine, Sapporo, Hokkaido, Japan
  1. Correspondence to Dr Hiroshi Nakase; hiropynakase{at}


A man in his 80s who had a history of diabetes mellitus and aortic valve replacement was referred to our hospital for treatment of early gastric cancer and underwent endoscopic submucosal dissection (ESD). Three days after ESD, the patient presented with low back pain and fever (38.7°). We initially considered adverse events associated with gastric ESD such as delayed perforation. Moreover, thromboembolism and infectious endocarditis were suspected because of his medical history. However, there were no remarkable findings suggestive of these diseases. Finally, based on the results of blood cultures and MRI, the diagnosis of pyogenic spondylitis (PS) was made. We administered antibiotics for 12 weeks, and the patient improved without neurological impairments. This case indicates that bacteraemia and subsequent PS can occur following gastric ESD. Physicians should not overlook the patient’s physical signs related to various adverse events after ESD.

  • Endoscopy
  • Bone and joint infections
  • Gastroenterology

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  • Contributors ST and GS conceived the study. ST and GS acquired clinical data. ST, GS, AY and HN interpreted clinical data. ST, GS and HN wrote the manuscript. HN performed critical revision of the article for important intellectual content.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Case reports provide a valuable learning resource for the scientific community and can indicate areas of interest for future research. They should not be used in isolation to guide treatment choices or public health policy.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.