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- W2952776430 abstract "In general, gastrointestinal perforation during endoscopic retrograde cholangiopancreatography and endoscopic ultrasonography (EUS) requires emergency surgery if endoscopic closure with a conventional clip is not successful. Recently, over-the-scope clip (OTSC) system has been recently used in management of gastrointestinal perforations. We herein report the case of a successful endoscopic closure with fat patch for an EUS-related large esophageal perforation using an OTSC. A 75-year-old man was scheduled for endoscopic ultrasound-guided fine needle aspiration for diagnosis of a pancreatic tumor. However, while inserting a side-viewing endoscope (GF-UCT260; Olympus) into the stomach, a large perforation measuring approximately 10 mm in diameter was developed in the posterior wall of the esophagogastric junction (Fig.1a). After recognizing the perforation, the procedure was immediately stopped, and a 9-mm OTSC (Ovesco Endoscopy GmbH, Tuebingen) was attached to the tip of the endoscope (GIF260J; Olympus). We reinserted the endoscope and sufficiently suctioned the normal mucosa surrounding the perforation site into the application cap (Fig.1b). Because it was confirmed that the fat surrounding the esophagogastric junction was suctioned into the application cap through the large perforation site, although it was for only about 1 s, we considered that the perforation site could be filled with the fat. We then carefully deployed an OTSC. The large perforation was endoscopically closed by intentionally plugging the perforation with the surrounding fat (Fig.1c). The patient successfully recovered without sequelae such as mediastinitis and peritonitis; normal diet was started 2 days later, and the patient was discharged 4 days after the procedure. A follow-up chest and abdominal computed tomographic image was taken 2 days after the procedure showed that the OTSC remained in place. It was assumed that the OTSC closed the esophageal perforation site by filling the perforation site with the fat surrounding the esophagogastric junction (Fig.1d). Our case strongly suggests that this endoscopic-patching-and-closure technique with an OTSC could be used to avoid emergency surgery for unforeseeable iatrogenic gastrointestinal perforations during diagnosis and treatment with a biliopancreatic endoscope such as endoscopic retrograde cholangiopancreatography and EUS in the future." @default.
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- W2952776430 date "2019-06-14" @default.
- W2952776430 modified "2023-09-27" @default.
- W2952776430 title "Gastrointestinal: Successful endoscopic fat patch with an over‐the‐scope clip for endoscopic ultrasonography‐related large esophageal perforation" @default.
- W2952776430 doi "https://doi.org/10.1111/jgh.14731" @default.
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