ArticleBMC gastroenterology2019
Clinical outcomes of iatrogenic upper gastrointestinal endoscopic perforation: a 10-year study.
Article in BMC gastroenterology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed, 28 citations in OpenAlex.
- Endoscopic closure technique performance for iatrogenic perforation: a systematic review and meta-analysis.iGIE : innovation, investigation and insights · 2026Review
- Intraoperative endoscopy: A controversial tool or a necessity in modern esophagogastric surgery?World journal of gastrointestinal surgery · 2025Review
- Endoscopic resection for gastric subepithelial tumours: a retrospective cohort study.Annals of medicine · 2025Article
- Review
- Application of natural orifice transluminal endoscopic surgery with ENDOCRAB system for stomach perforation model: ex vivo porcine study.Scientific reports · 2024Article
- Article
- Robotic surgery in the management of synchronous esophageal and gastric perforation after endoscopic dilation.BMJ case reports · 2024Article
- Prediction of Severity and Adverse Outcomes Associated with Perforation in Patients Presenting to the Emergency Department with Esophageal Injury.The Korean journal of helicobacter and upper gastrointestinal research · 2023Article
- Experience of management of pediatric upper gastrointestinal perforations: a series of 30 cases.Frontiers in pediatrics · 2023Article
- Gastric Perforation Encountered during Duodenal Stent Insertion.The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2022Article
- Cost-effectiveness of screening with polymerase chain reaction forJournal of gastrointestinal oncology · 2022Article
- Gastrointestinal endoscopy and visceral surgery: current status and potentials for interdisciplinary patient care.Therapeutic advances in gastrointestinal endoscopyReview
- Current endoscopic closure techniques for the management of gastrointestinal perforations.Therapeutic advances in gastrointestinal endoscopyReview
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Authors and funding
7 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUpper gastrointestinal endoscopic examination is a relatively safe procedure; however, all endoscopic procedures are invasive and are associated with a risk of iatrogenic perforation. To evaluate clinical outcomes of iatrogenic upper gastrointestinal endoscopic perforation. Factors associated with surgical management or mortality were analyzed.
methodsBetween November 2008 and November 2018, the medical records of 149,792 upper gastrointestinal endoscopic procedures were evaluated. The mechanisms of perforations were categorized as electrocoagulation-induced or blunt trauma-induced injuries. The incidence and clinical outcomes of iatrogenic perforations based on the types of procedures performed were evaluated.
resultsIatrogenic endoscopic perforations occurred in 28 cases (0.019%). Iatrogenic perforation-related mortality occurred in 3 patients. The iatrogenic perforation rate based on the types of procedures performed was as follows: diagnostic endoscopy = 0.002%, duodenal endoscopic mucosal resection = 0.9%, esophageal endoscopic submucosal dissection = 10.7%, gastric endoscopic submucosal dissection = 0.2%, endoscopic self-expandable metal stent insertion for malignant esophageal obstruction = 0.1%, duodenoscope-induced injury = 0.02%, endoscopic sphincterotomy = 0.08%, and ampullectomy = 6.8%. All electrocoagulation-induced perforations (n = 21) were managed successfully (15 cases of endoscopic closure, 5 cases treated conservatively, and 1 case treated surgically). Three patients died among those with blunt trauma-induced perforations (n = 7). The factors associated with surgical management or mortality were old age, poor performance status (Eastern Cooperative Oncology Group score ≥ 1), advanced malignancy, and blunt trauma.
conclusionsMost cases of electrocoagulation-induced iatrogenic perforations can be treated using endoscopic clips. If endoscopic closure fails for blunt trauma-induced perforations, prompt surgical management is mandatory.
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