Detection of early hidden carcinoma of cardia by reversely entering the esophagus with magnetically controlled capsule endoscopy: A case report

Magnetically controlled capsule endoscopy (MCE) is a non-invasive method for gastropathy examination. However, due to the influence of gravity and lumen structure, the traditional capsule endoscopy rapidly passes through the cardia, leading to insufficient observation of the cardia mucosa. Case Summary. The patient, a 53-year-old male, had a history of subarachnoid hemorrhage for 5 years, and it has been 5 years since the aneurysm embolization.Computed Tomography Angiography (CTA) indicated the presence of an anterior cruciate aneurysm. Given the risks associated with traditional intubated gastroscopy, magnetic controlled capsule gastroscopy was chosen for gastric examination. Following the standard operating procedure, routine magnetic controlled capsule endoscopy was performed, and no lesions were detected.We combined magnetic force and patient posture adjustment to guide the capsule to pass through the cardia slowly and return to the esophagus, successfully detecting a concealed cardia lesion.Afterwards, the lesions of the cardia were treated with a magnifying gastroscope and endoscopic submucosal dissection (ESD).Pathological findings showed that adenocarcinoma was confined to the mucosa membrane, and in the postoperative pathological study, no tumor remnants or metastasis were discovered. This paper reports a case of a patient undergoing a physical examination, but no lesion was found during a routine examination using the magnetically controlled capsule gastroscope. However, we discovered a case of hidden early cardia cancer after guiding the capsule gastroscope back into the esophagus under magnetic control.