GASTROENTEROLOGY ARTICLE OF THE WEEK
January 9, 2003
ASGE. Complications of Upper GI Endoscopy. Gastrointestinal Endosc 2002;55:784-793.
1. Complications related to sedation account for what percent of UGI endoscopic complications
a. 5 - 10%
b. 20 - 25%
c. 40 - 46%
d. 75% - 80%
2. Esophageal perforation during endoscopy
a. occurs in 0.03% of cases
b. if suspected can be confirmed by doing a barium swallow
c. pain is the most common symptom
d. risk factors include Zenker’s diverticulum, cervical osteophytes, esophageal
stricture and malignancy
3. PEG
a. carries a procedure-related 30-day mortality of 0-2%
b. minor complications occur in 13% to 43% of patients
c. periostomal infection is rare, occurring in less than 10%
d. inadequate length of “stab incision” may lead to necrotizing fasciitis
e. pneumoperitoneum noted the day after PEG placement is an indication for
surgical exploration
True or False
4. Risk of perforation during pneumatic dilation for achalasia is approximately 5%
5. Esophageal strictures due to caustic ingestion are more likely to perforate during dilation than peptic strictures.
6. The overall complication rate of UGI endoscopy is 0.13% with a mortality rate of 0.004%
7. Complications of dilation are less when balloons are used rather than push dilators.
8. Pyloric dilations should be limited to 15mm diameter.
9. The use of heater probe to achieve hemostasis carries up to 4% risk of perforation if a second session is performed 24 to 48 hours after the initial one.
10. PDT for esophageal tumors results in almost immediate improvement in dysphagia.
11. Complications from esophageal stents occur in 20%-40% with death in 3%. Chest pain occurs in 20%
12. Endoscopic variceal sclerotherapy
a. has a complication rate of 35% to 78%, and a perforation rate of 2% to 5%
b. esophageal strictures develop in 75% of patients
c. 5% may develop aspiration pneumonia
d. complications are more common than with banding
13. Esophageal band ligation
a. esophageal ulceration occurs in 5% to 15%
b. perforation rate is about 0.7%, mostly associated with the use of an overtube
c. aspiration pneumonia is seen in 25%
d. mortality rate is 1%