title: Algorithm for the management of endoscopic perforations: a quality improvement project.
abstract: Perforations are an uncommon but serious complication of endoscopy. Although they are well recognized, no universally accepted strategy for their management exists. The need for management algorithms in situations that call for multiple interventions in a short time, with coordinated effort encompassing multiple providers from different specialties, has long been recognized, but no such clinical care pathway has been developed for the management of endoscopic perforations. Since perforations are uncommon, a predetermined plan of action can streamline patient management. Furthermore, such a plan demonstrates preparedness on the part of the gastroenterologist. We developed an endoscopic perforation management strategy based on the best available scientific evidence and our specific resources. We report our experience in the hope that it may form a useful framework for gastroenterologists attempting to do the same at their own institution.
authors.affiliation: Division of Gastroenterology, Hepatology, and Nutrition, University of Florida, Gainesville, Florida, USA.
authors.forename: Lukasz
authors.initials: L
authors.lastname: Kowalczyk
authors.forename: Chris E
authors.initials: CE
authors.lastname: Forsmark
authors.forename: Kfır
authors.initials: K
authors.lastname: Ben-David
authors.forename: Mihir S
authors.initials: MS
authors.lastname: Wagh
authors.forename: Shailendra
authors.initials: S
authors.lastname: Chauhan
authors.forename: Dennis
authors.initials: D
authors.lastname: Collins
authors.forename: Peter V
authors.initials: PV
authors.lastname: Draganov
mesh_terms: D000328:Adult; D000368:Aged; D000465:Algorithms; D003131:Combined Modality Therapy; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects* / Q000379:methods; D005260:Female; D005431:Florida; D005762:Gastroenterology / Q000592:standards / Q000639:trends; D006801:Humans; D007416:Intestinal Perforation / Q000453:epidemiology / Q000209:etiology / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D058996:Quality Improvement; D018570:Risk Assessment; D013514:Surgical Procedures, Operative / Q000379:methods; D016896:Treatment Outcome