BACKGROUND: Endoscopy has assumed a significant role in the management of gastrointestinal disorders. However, endoscopic-related injuries are poorly reported. METHODS: Review of our surgical database (1980-2006) identified all patients age 18 years or younger with an endoscopic-related injury managed at our institution. RESULTS: A total of 3269 colonoscopies were performed; there were 3 iatrogenic perforations (incidence, 0.09%). All were managed operatively: 2 underwent fecal diversion, and 1 was repaired primarily. There was 1 postoperative complication (internal hernia) and no deaths related to colonoscopic perforation. Nine thousand three hundred eight esophagogastroduodenoscopy (EGD) procedures were performed, resulting in 6 iatrogenic injuries (0.06%): bleeding (2), perforation (2), and mucosal tears (2) (0.02% each). All EGD-related injuries occurred in the esophagus except for 1 duodenal perforation which was managed operatively by primary repair. Both patients with bleeding complications underwent repeat endoscopy and cautery with satisfactory results. The other 3 patients were managed conservatively without complication. Three hundred eighty-nine endoscopic retrograde cholangiopancreatogram procedures were performed with 2 iatrogenic injuries (0.5%): 1 bleed and 1 perforation (0.25% each). Both were managed conservatively without complication. CONCLUSION: Endoscopic injuries are uncommon. Colonoscopic perforations require prompt surgical intervention. Esophagogastroduodenoscopy- and endoscopic retrograde cholangiopancreatogram-related injuries are amenable to conservative therapy in clinically stable patients devoid of peritonitis.
BACKGROUND: Endoscopy has assumed a significant role in the management of gastrointestinal disorders. However, endoscopic-related injuries are poorly reported. METHODS: Review of our surgical database (1980-2006) identified all patients age 18 years or younger with an endoscopic-related injury managed at our institution. RESULTS: A total of 3269 colonoscopies were performed; there were 3 iatrogenic perforations (incidence, 0.09%). All were managed operatively: 2 underwent fecal diversion, and 1 was repaired primarily. There was 1 postoperative complication (internal hernia) and no deaths related to colonoscopic perforation. Nine thousand three hundred eight esophagogastroduodenoscopy (EGD) procedures were performed, resulting in 6 iatrogenic injuries (0.06%): bleeding (2), perforation (2), and mucosal tears (2) (0.02% each). All EGD-related injuries occurred in the esophagus except for 1 duodenal perforation which was managed operatively by primary repair. Both patients with bleeding complications underwent repeat endoscopy and cautery with satisfactory results. The other 3 patients were managed conservatively without complication. Three hundred eighty-nine endoscopic retrograde cholangiopancreatogram procedures were performed with 2 iatrogenic injuries (0.5%): 1 bleed and 1 perforation (0.25% each). Both were managed conservatively without complication. CONCLUSION: Endoscopic injuries are uncommon. Colonoscopic perforations require prompt surgical intervention. Esophagogastroduodenoscopy- and endoscopic retrograde cholangiopancreatogram-related injuries are amenable to conservative therapy in clinically stable patients devoid of peritonitis.
Authors: Nicola de'Angelis; Salomone Di Saverio; Osvaldo Chiara; Massimo Sartelli; Aleix Martínez-Pérez; Franca Patrizi; Dieter G Weber; Luca Ansaloni; Walter Biffl; Offir Ben-Ishay; Miklosh Bala; Francesco Brunetti; Federica Gaiani; Solafah Abdalla; Aurelien Amiot; Hany Bahouth; Giorgio Bianchi; Daniel Casanova; Federico Coccolini; Raul Coimbra; Gian Luigi de'Angelis; Belinda De Simone; Gustavo P Fraga; Pietro Genova; Rao Ivatury; Jeffry L Kashuk; Andrew W Kirkpatrick; Yann Le Baleur; Fernando Machado; Gustavo M Machain; Ronald V Maier; Alain Chichom-Mefire; Riccardo Memeo; Carlos Mesquita; Juan Carlos Salamea Molina; Massimiliano Mutignani; Ramiro Manzano-Núñez; Carlos Ordoñez; Andrew B Peitzman; Bruno M Pereira; Edoardo Picetti; Michele Pisano; Juan Carlos Puyana; Sandro Rizoli; Mohammed Siddiqui; Iradj Sobhani; Richard P Ten Broek; Luigi Zorcolo; Maria Clotilde Carra; Yoram Kluger; Fausto Catena Journal: World J Emerg Surg Date: 2018-01-24 Impact factor: 5.469
Authors: Benjamin Schiller; Michael Radke; Christina Hauenstein; Carsten Müller; Christian Spang; Daniel A Reuter; Jan Däbritz; Johannes Ehler Journal: Medicina (Kaunas) Date: 2021-12-22 Impact factor: 2.430