Iatrogenic pyriform sinus perforation during endoscopic ultrasonography

• Main Authors: Young Min Kim (Author), Jae Jun Park (Author), Young Hoon Youn (Author)
• Format: Book
• Published: Society of Gastrointestinal Intervention, 2019-01-01T00:00:00Z.
• Subjects: article
• Online Access: Connect to this object online.
• Notes: 2636-0012; 10.18528/ijgii190004
• Keywords: Endoscopic ultrasonography; Iatrogenic perforation; Pyriform sinus; Medicine; R; Internal medicine; RC31-1245; Specialties of internal medicine; RC581-951; Neoplasms. Tumors. Oncology. Including cancer and carcinogens; RC254-282
• Source: International Journal of Gastrointestinal Intervention, Vol 8, Iss 1, Pp 59-61 (2019)

Summary of Event A 65-year-old women underwent endoscopic ultrasonography (EUS) to evaluate the gastric submucosal tumor. The EUS scope was inserted into the esophagus after two attempts. A neck computed tomography (CT) scan showed a pneumomediastinum and an air bubble deep in the neck, suggesting an esophageal rupture. The patient was hospitalized and maintained conservative treatment including broad-spectrum antibiotics and withholding oral feeding. Teaching Point Endoscopists should consider an imaging modality when a patient complains of moderate to severe neck pain after an upper endoscopy. Prompt surgical management should be considered in patients with a delayed diagnosis (> 24 hours), those with signs of systemic toxicity, and those who have eaten between the time of the procedure and when the perforation was detected.