Dehiscence following successful endoscopic closure of gastric perforation during endoscopic submucosal dissection.
Gastric perforation is one of the most serious complications that can occur during endoscopic submucosal dissection (ESD). In terms of the treatment of such perforations, we previously reported that perforations immediately observed and successfully closed with endoclips during endoscopic resection could be managed conservatively. We now report the first case in our medical facility of a gastric perforation during ESD that was ineffectively treated conservatively even after successful endoscopic closure. In December 2006, we performed ESD on a recurrent early gastric cancer in an 81-year-old man with a medical history of laparotomy for cholelithiasis. A perforation occurred during ESD that was immediately observed and successfully closed with endoclips so that ESD could be continued resulting in an en-bloc resection. Intensive conservative management was conducted following ESD, however, an endoscopic examination five days after ESD revealed dehiscence of the perforation requiring an emergency laparotomy.
Endoscopy Division, National Cancer Center Hospital, Tokyo 104-0045, Japan.
Masau
M
Sekiguchi
Haruhisa
H
Suzuki
Ichiro
I
Oda
Shigetaka
S
Yoshinaga
Satoru
S
Nonaka
Makoto
M
Saka
Hitoshi
H
Katai
Hirokazu
H
Taniguchi
Ryoji
R
Kushima
Yutaka
Y
Saito
D000230:Adenocarcinoma / Q000601:surgery; D000369:Aged, 80 and over; D004724:Endoscopy / Q000009:adverse effects*; D004868:Equipment Failure; D005753:Gastric Mucosa / Q000293:injuries*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D013274:Stomach Neoplasms / Q000601:surgery*; D013525:Surgical Instruments / Q000009:adverse effects; D013529:Surgical Wound Dehiscence / Q000175:diagnosis* / Q000601:surgery; D016896:Treatment Outcome