Acetic Acid and Blue Light Highlight Sessile Serrated Lesions
Douglas K. Rex, MD, MASGE, reviewing Yamamoto S, et al. Gastrointest Endosc 2020 Jul 14.
This case study demonstrates how acetic acid in combination with blue-light imaging (BLI), a relatively new mode of chromoendoscopy technology, highlights sessile serrated lesions (SSLs). As is well known, SSLs can be hard to delineate, but the borders may be enhanced by blue light. The technique demonstrated here is to spray 1.7% acetic acid on the lesion, which dissolves the mucus on the surface of the polyp and turns the polyp surface a white (snowflake effect) color. The lesion is then particularly well-delineated in blue light.
COMMENTThis technique would seem particularly valuable if piecemeal cold resection of a serrated lesion is planned without injection. If submucosal injection with a contrast agent is planned for resection, then the contrast typically provides excellent delineation of the margin.
Note to readers: At the time we reviewed this paper, its publisher noted that it was not in final form and that subsequent changes might be made.
CITATION(S)
Yamamoto S, Varkey J, Bhandari P. Acetoelectronic chromoendoscopy for sessile serrated polyp. Gastrointest Endosc 2020 Jul 14. (Epub ahead of print) (https://doi.org/10.1016/j.gie.2020.07.008)
