| Theme | Advancement of Medical Practice for Peritonitis and Ascites | |
|---|---|---|
| Title | Treatment Strategy for Endoscopy Induced Peritonitis | |
| Publish Date | 2019/07 | |
| Author | Atsuko Ohki | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| Author | Masanao Tsurumi | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| Author | Yoshikazu Hashimoto | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| Author | Gen Nagao | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| Author | Hirohisa Takeuchi | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| Author | Nobutsugu Abe | Department of Gastrointestinal & General Surgery, Kyorin University School of Medicine |
| [ Summary ] | Recently, endoscopic therapy is being increasingly used in clinical practice, and perforation‒induced peritonitis is known to occur in a few cases. In patients with endoscopy induced gastric perforation, closure of the perforation site is important for postoperative management. An emergency operation is necessary in cases of delayed perforation. Perforation of the bile duct by an endoscopic retrograde cholangiopancreatography guidewire is usually treated conservatively. Emergency operation should be considered in patients with large duodenal perforations, patients with severe pain, and patients without biliary drainage. The rate of delayed perforation is high after endoscopic resection of duodenal lesions, and the timing of surgery is important in such cases. Colonic perforation after endoscopic resection can cause severe peritonitis in patients with inadequate/inappropriate preoperative preparation. Adequate closure of the colonic perforation site is important for postoperative management. Treatment strategies need to be individualized based on the characteristics of each organ in cases of endoscopy induced perforations. | |