Esophageal perforation as a complication of esophagogastroduodenoscopy

✍ Scribed by Nisha L. Bhatia; Joseph M. Collins; Cuong C. Nguyen; Dawn E. Jaroszewski; Holenarasipur R. Vikram; Joseph C. Charles

• Book ID: 102338617
• Publisher: John Wiley and Sons
• Year: 2008
• Tongue: English
• Weight: 186 KB
• Volume: 3
• Category: Article
• ISSN: 1553-5592
• DOI: 10.1002/jhm.289

✦ Synopsis

Abstract

Fifty years ago, esophageal perforation was common after rigid upper endoscopy. The arrival of flexible endoscopic instruments and refinement in technique have decreased its incidence; however, esophageal perforation remains an important cause of morbidity and mortality. This complication merits a high index of clinical suspicion to prevent sequelae of mediastinitis and fulminant sepsis. Although the risk of perforation with esophagogastroduodenoscopy alone is only 0.03%, this risk can increase to 17% with therapeutic interventions in the setting of underlying esophageal and systemic diseases. A wide spectrum of management options exist, ranging from conservative treatment to surgical intervention. Prompt recognition and management, within 24 hours of perforation, is critical for favorable outcomes. Journal of Hospital Medicine 2008;3:256–262. © 2008 Society of Hospital Medicine.