Theme |
Countermeasures of adverse events in therapeutic endoscopy |
Title |
Management of bleeding and perforations related to endoscopic mucosal resection |
Author |
Chihiro Yasue |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Shoichi Saito |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Yusuke Nishikawa |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Daisuke Ide |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Akiko Chino |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Yoshiro Tamegai |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
Author |
Masahiro Igarashi |
Department of Gastroenterology, Cancer Institute Hospital of JFCR |
[ Summary ] |
Treatments for major complications, including intestinal bleeding and perforations after endoscopic mucosal resection (EMR) are illustrated. Those complications are noted in relation to their causes and solutions. Initially we must inform patients concerning the possibility of potential risks before endoscopic treatment. Active bleeding, one common complication due to endoscopic resection, can be managed with hemostasis using endoclips. In cases involving EMR for large superficial lesions existing on the bowel fold at the cecum or ascending colon, it is necessary to carefully avoid grasping the tissues of the muscle layer proper to prevent perforations. In most of cases, complications are manageable with conservative care employing appropriate methods as soon as possible. |