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CC BY-NC-ND 4.0 · Journal of Digestive Endoscopy 2022; 13(02): 113-115
DOI: 10.1055/s-0042-1746424
Endoscopy Video

Endoscopic Closure of Large Iatrogenic Duodenal Perforation: Right Use of Endoscopic Accessories

Naveen Kumar
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Deshidi Srinu
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Rinkal Kakadiya
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Kailash Chand Kurdia
2   Department of General Surgery, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Vaneet Jearth
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
,
Jimil Shah
1   Department of Gastroenterology, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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Abstract

Perforations during endoscopic retrograde cholangiopancreatography (ERCP) is a rare but dreadful complication. Type I Stapfer's perforations tend to be large and can get easily complicated by peritonitis and collections if not recognized and managed in a timely manner. With advancement in endoscopic accessories, endoscopic closure is usually attempted first, and surgical interventions are reserved only in patients with a failed endoscopic attempt. Though over the scope clips (OTSC) are used in patients with defect up to 20 to 25 mm in gastric or duodenal perforation and up to 30 mm in colonic perforations, larger defects can be also closed with the right use of adjuvant accessories. Here, we report our experience of successful closure of a large duodenal perforation during ERCP, using a single OTSC clip with help of accessories.

Keywords

conservative - endoscopy - OVESCO

Authors' contributions

NK: video editing, data acquisition, and final approval of the manuscript.


RK, KCK, VJ, RK: critical revision of the manuscript, video editing, and final approval of the manuscript.


JS: conceptualization of the study, critical revision of the manuscript, video editing, and final approval of the manuscript.




Publication History

Article published online:
05 July 2022

© 2022. Society of Gastrointestinal Endoscopy of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • Reference:

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