Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Paspatis, Gregorios A.; Dumonceau, Jean‐Marc; Barthet, Marc; Meisner, Søren; Repici, Alessandro; Saunders, Brian P.; Vezakis, Αntonios; Gonzalez, Jean Michel; Turiño, Stine Ydegaard; Tsiamoulos, Zacharias P.; Fockens, Paul; Hassan, Cesare

doi:10.1055/s-0034-1377531

Cited by 316 publications

(307 citation statements)

References 258 publications

(149 reference statements)

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“…Algunos grupos indican tratamiento quirúrgico con la colocación de un tubo en T en el colédoco, duodenostomía, diverticulización duodenal o exclusión pilórica (9,15). Otros autores, incluidas las guías de la Sociedad Europea de Endoscopia Gastrointestinal (ESGE, por sus siglas en inglés), recomiendan evaluar el mecanismo, la extensión de la lesión y el tiempo trascurrido al momento del diagnós-tico para definir un tratamiento conservador, junto con la aplicación de clips, o indicar manejo quirúrgico (7,14,16). En Colombia, en el estudio realizado por Peñaloza y colaboradores en el hospital San José de Bogotá, en 372 pacientes, se encontró una incidencia de perforación post-CPRE del 1,3% (17).…”

Section: Discussionunclassified

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

M¹,

P²,

et al. 2017

Rev. Colomb. Gastroenterol.

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La perforación duodenal posterior a la colangiopancreatografía endoscópica (CPRE) es una complicación infrecuente que sucede en un 0.1-0.6% de los casos. El manejo (quirúrgico o no quirúrgico) depende de varios factores. Presentamos el caso de una mujer que sufrió una perforación duodenal pos-CPRE manejada conservadoramente con un stent biliar metálico autoexpandible (SMAE) totalmente recubierto y antibióticos, quien no requirió manejo quirúrgico.

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Section: Discussionunclassified

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

M¹,

P²,

et al. 2017

Rev. Colomb. Gastroenterol.

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“…Even if all above negative image studies, up to 10% cases of perforation could not be detected. [8] According to 2014 European Society of Gastrointestinal Endoscopy (ESGE) guideline for managements of iatrogenic endoscopic perforations, [9] treating endoscopy related duodenal perforation depends on recognition time (instant or delayed > 24 hour), whether pos-sible endoscopic closure after immediate recognition, and any extravasation on CT finding. But the evidences are almost coming from ERCP related duodenal perforation.…”

Section: Discussionmentioning

confidence: 99%

Pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum secondary to afferent loop perforation after upper endoscopy in patient with Billroth II gastrectomy

Hou

Chen

Shih

2016

CRIM

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Complications related by upper endoscopy include bleeding, perforation and infections but they are rare on simply diagnostic endoscopy. Duodenal perforation is less common but mortality rates are high. Diagnosis is based on keeping high suspicion that makes early detection to offer optimal treatments and better outcomes. Surgical intervention is standard treatment but some cases could benefit from conservative care. However, there was little literature description of afferent loop perforation after upper endoscopy. Herein, we report a case of pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum secondary to afferent loop perforation after upper endoscopy in patient with Billroth II gastrectomy. This rare case should be the reminder for physicians carefully performing upper endoscopy in patients with Billroth-II gastrectomy and keeping high suspicion of perforation after endoscopy if abdominal pain.

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“…Successful treatment of such perforation with clips has been reported. 39 Patient should be positioned appropriately so that the fluid pool is away from perforation thereby minimizing peritoneal contamination 40 and perforation closed by placing clips on the superior portion of sphincterotomy thereby avoiding pancreatic and bile duct orifice injury. Anastomotic leak after colon surgery is a serious complication with incidence of 3% and mortality rate of 10.1%.…”

Section: Endoscopic Clipsmentioning

confidence: 99%

Endoscopic management of postoperative fistulas and leaks

Devaraj

Gavini

2017

Int J Gastrointest Interv

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Postoperative complications from gastrointestinal surgery can be associated with significant morbidity, and mortality especially if repeat surgery is needed to address these complications. There are wide array of endoscopic interventions and tools available for management of these complications using minimally invasive methods thus decreasing length of hospitalization, morbidity and leading to better patient outcomes. With the advent new tools like Overstitch device, Over the Scope Clip, fibrin glue, etc., these complications can be managed successfully with minimal morbidity. We provide an indepth discussion about available endoscopic options and their application in various scenarios in our article. Endoscopist should be familiar with these complications and endoscopic tools to promote use of these tools and techniques to achieve successful management of these complex conditions.

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Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement

Cited by 316 publications

References 258 publications

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

Perforación duodenal pos-CPRE de manejo no quirúrgico: reporte de un caso

Pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum secondary to afferent loop perforation after upper endoscopy in patient with Billroth II gastrectomy

Endoscopic management of postoperative fistulas and leaks

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