title: Closing perforations and postperforation management in endoscopy: duodenal, biliary, and colorectal.
abstract: Early recognition of adverse events arising from endoscopy is essential. In some cases the injury can be viewed clearly during the procedure, and immediate action should be taken to repair the defect endoscopically if feasible. If perforation is unclear, imaging can be used to confirm the diagnosis. Surgical intervention is not always necessary; however, a surgical consultation for backup is essential. Selective cases can be managed conservatively or endoscopically with successful outcomes. Early recognition and intervention, input from specialist colleagues, and communication with the patient and family are keys to successfully managing the event.
authors.affiliation: Department of Medicine, Staten Island University Hospital, 475 Seaview Avenue, Staten Island, NY 10305, USA.
authors.forename: Christine
authors.initials: C
authors.lastname: Boumitri
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY 10021, USA.
authors.forename: Nikhil A
authors.initials: NA
authors.lastname: Kumta
authors.affiliation: Division of Gastroenterology, Robert Wood Johnson Medical School, 501 Fellowship Road, Mount Laurel, NJ 08054, USA.
authors.forename: Milan
authors.initials: M
authors.lastname: Patel
authors.affiliation: Division of Gastroenterology and Hepatology, Weill Cornell Medical College, 1305 York Avenue, 4th Floor, New York, NY 10021, USA. Electronic address: mkahaleh@gmail.com.
authors.forename: Michel
authors.initials: M
authors.lastname: Kahaleh
mesh_terms: D001652:Bile Ducts / Q000293:injuries; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects; D003106:Colon / Q000293:injuries; D004386:Duodenum / Q000293:injuries; D016099:Endoscopy, Gastrointestinal / Q000009:adverse effects*; D006801:Humans; D007416:Intestinal Perforation / Q000601:surgery*; D011182:Postoperative Care / Q000379:methods*; D012007:Rectum / Q000293:injuries; D016896:Treatment Outcome; D058106:Wound Closure Techniques
keywords: Closure; Endoscopic retrograde cholangiopancreatography; Endoscopy; Interventional radiology; Over-the-scope clips; Perforation; Surgery; Through-the-scope clips