Central Surgical AssociationEsophagogastroduodenoscopy-associated gastrointestinal perforations: A single-center experience
Section snippets
Methods
Institutional review board approval was obtained. The procedure database at our institution was searched to identify all patients undergoing EGD from January 1996 through July 2008 exclusive of percutaneous endoscopic gastrostomy, endoscopic ultrasonography, endoscopic retrograde cholangiopancreatography, transthoracic echocardiography, and concurrent colonoscopy procedures. This subset was further narrowed down by 2 methods: (1) all patients diagnosed with “perforation” within 7 days of the
Results
We performed 217,507 EGD procedures between January 1996 and July 2008. The number of EGDs performed increased steadily from 12,183 in 1996 to >19,000 in 2008 (Figure). We included 72 patients from our institution and 5 patients transferred to our institution (46 women, 31 men), with a median age of 70 years (range, 20–95) who had an EGD-associated GI perforation. The overall incidence of perforation for EGDs performed at our institution was 0.03%. Of these procedures, 124,844 EGDs (57%)
Discussion
EGD has proven to be a safe therapeutic and diagnostic procedure in most patients. Despite its relative safety, iatrogenic perforations of the GI tract may have severe consequences.1, 2, 3, 5, 6, 7, 8, 11, 12 To the authors' knowledge, this study is the largest single-institution experience with GI perforations secondary to EGD. With rising use of EGD, particularly for more aggressive therapeutic uses including natural orifice transluminal endoscopic surgery (NOTES), there exists a need to
References (18)
- et al.
Endoscopic complications: the Texas experience
Gastrointest Endosc
(1979) - et al.
Complications of upper gastrointestinal endoscopy and their management
Gastrointest Endosc Clin N Am
(1994) - et al.
Instrumental perforations of the esophagus
Dis Chest
(1969) - et al.
Management of instrumental perforations of the esophagus
J Thorac Cardiovasc Surg
(1982) - et al.
Prospective evaluation of complications in an endoscopy unit: use of the A/S/G/E quality care guidelines
Gastrointest Endosc
(1992) - et al.
Complications of upper GI endoscopy
Gastrointest Endosc
(2002) Complications of upper gastrointestinal endoscopy
Gastrointest Endosc Clin N Am
(1996)- et al.
Diagnosis and recommended management of esophageal perforation and rupture
Ann Thorac Surg
(1986) Complications of endoscopic gastrointestinal dilation techniques
Gastrointest Endosc Clin N Am
(1996)
Cited by (72)
Treatment of esophageal perforation: A review of our experience at a tertiary referral hospital spanning the past 19 years
2022, Revista de Gastroenterologia de MexicoAGA Technical Review on Gastrointestinal Evaluation of Iron Deficiency Anemia
2020, GastroenterologyNovel endoscopic modalities for closure of perforations, leaks, and fistula in the gastrointestinal tract
2019, Techniques in Gastrointestinal EndoscopyEndoscopic diagnosis and treatment of disorders of upper esophageal sphincter function
2018, Techniques in Gastrointestinal EndoscopyEndoscopic "rescue" treatment for gastrointestinal perforations, anastomotic dehiscence and fistula
2016, Clinics and Research in Hepatology and GastroenterologyClassification of the oesophageal perforation
2023, Research Square