Esophageal perforation as a complication of esophagogastroduodenoscopy.
Fifty years ago, esophageal perforation was common after rigid upper endoscopy. The arrival of flexible endoscopic instruments and refinement in technique have decreased its incidence; however, esophageal perforation remains an important cause of morbidity and mortality. This complication merits a high index of clinical suspicion to prevent sequelae of mediastinitis and fulminant sepsis. Although the risk of perforation with esophagogastroduodenoscopy alone is only 0.03%, this risk can increase to 17% with therapeutic interventions in the setting of underlying esophageal and systemic diseases. A wide spectrum of management options exist, ranging from conservative treatment to surgical intervention. Prompt recognition and management, within 24 hours of perforation, is critical for favorable outcomes.
Division of Hospital Internal Medicine, Mayo Clinic Arizona, Phoenix, Arizona, USA. bhatia.nisha@mayo.edu
Nisha L
NL
Bhatia
Joseph M
JM
Collins
Cuong C
CC
Nguyen
Dawn E
DE
Jaroszewski
Holenarasipur R
HR
Vikram
Joseph C
JC
Charles
D016145:Endoscopy, Digestive System / Q000009:adverse effects*; D004939:Esophageal Perforation / Q000175:diagnosis / Q000209:etiology / Q000628:therapy*; D004947:Esophagus / Q000033:anatomy & histology; D006801:Humans; D012307:Risk Factors