Open AccessCervical esophageal perforation during endoscopic ultrasonography: A retrospective evaluation of frequency, outcome, and patient management
Author(s) -
Yu ChiaYing,
Chien ChengHung,
Hsieh PoJen,
Chien RongNan
Publication year - 2018
Publication title -
advances in digestive medicine
Language(s) - English
Resource type - Journals
ISSN - 2351-9800
DOI - 10.1002/aid2.13085
Subject(s) - medicine , perforation , surgery , retrospective cohort study , esophageal cancer , complication , esophagus , intubation , radiology , general surgery , cancer , materials science , punching , metallurgy
To analyze the indications and complications of diagnostic endoscopic ultrasonography (EUS) within a 12‐year period in our hospital. We retrospectively reviewed all patients who received upper gastrointestinal EUS at Keelung Chang Gung Memorial Hospital from January 2002 to December 2013. The examination was performed using a radial scanning echo endoscope (Olympus GF‐UMQ 240 before August 2011; Olympus GF‐UE 260‐AL5 after September 2011). The indications as well as complications were reviewed. A total of 839 patients underwent a total of 1036 procedures. Mean age of the patients was 59 years (range, 16‐102 years); 56.3% of patients were men. The indications for EUS were: evaluation of gastric submucosal tumors in 425 patients (41%), esophageal cancer staging in 247 patients (23.8%), evaluation of esophageal submucosal tumors in 91 patients (8.8%), evaluation of pancreatic lesions in 66 patients (6.4%), gastric cancer staging in 66 patients (6.4%), and evaluation of biliary lesions in 53 patients (5.1%). Only one patient (0.096%) developed a major complication (cervical esophageal perforation). Fortunately, the patient recovered smoothly after a surgical repair and felt well at 5‐year follow up. Cervical esophageal perforation is a rare but catastrophic complication of EUS. Advanced age, history of difficult intubation, cervical osteophytes, and less experienced doctors are documented to be the risk factors for perforation. In addition, surgeons should pay more attention to those who have a history of thyroidectomy. Immediate recognition of the perforation and urgent primary surgical repair results in a favorable outcome.