Endoscopy 2019; 51(04): S202-S203
DOI: 10.1055/s-0039-1681772
ESGE Days 2019 ePosters
Friday, April 5, 2019 09:00 – 17:00: Clinical Endoscopic Practice ePosters
Georg Thieme Verlag KG Stuttgart · New York

ENDOSCOPIC MANAGEMENT OF EUS RELATED DUODENAL PERFORATION

H El Bacha
1   Medecine b, Hopital Ibn-Sina, Rabat, Morocco
2   Faculte de Medecine, University Mohammed V, Rabat, Morocco
,
S Leblanc
3   Gastro Enterologie, Hopital Cochin, Paris, France
,
B Bordacahar
3   Gastro Enterologie, Hopital Cochin, Paris, France
,
B Brieau
3   Gastro Enterologie, Hopital Cochin, Paris, France
,
M Barret
3   Gastro Enterologie, Hopital Cochin, Paris, France
,
F Prat
3   Gastro Enterologie, Hopital Cochin, Paris, France
› Author Affiliations
Further Information

Publication History

Publication Date:
18 March 2019 (online)

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Aims:

Endoscopic ultrasonography (EUS) has a wide application in upper gastrointestinal and biliopancreatic disorders assessment.

EUS experience low complication rate. Perforation is one of the most deemed complication. Surgery allows simultaneous treatment of the perforation and of the biliary disorder. However, surgery is still an invasive treatment carrying its own morbidity and mortality. The aim of our study is to assess feasibility and safety of conservative treatment with over the scope clips (OTSC) in EUS related GI perforation.

Methods:

We performed a retrospective study of patients with EUS related iatrogenic perforation from 2011 to 08/2018.

We included patients with EUS related perforation, with immediate diagnosis, and a conservative endoscopic management. Patient with initial surgical management were excluded.

Results:

12 perforations in 8504 EUS procedure occurred (0.14%).

1 patient was ruled out due to a delayed diagnosis and initial surgical management.

A total of 11 patients were included, all women. The mean patient age was 75 (range 68 – 88) years. 8/11 (72.7%) perforations were due to a radial scope. All procedures were performed at a diagnostic end.

Perforations were located in the superior flexure of the duodenum in 9/11 (81%), in the descending part of the duodenum 1/11 (9%), and in the inferior duodenal flexure 1/11 (9%). The size of the defect was ranged from 10 – 15 mm.

All clipping procedures experienced a technical and clinical success.

3/11 (27%) had a stay in intensive care unit for less than 72h, total hospital stay ranged from 3 – 22days.

Conclusions:

Proper indication is mandatory for EUS procedure in elderly people. Conservative endoscopic treatment with OTSC clips represent a feasible and safe treatment for EUS related duodenal perforation.