Dehiscence following successful endoscopic closure of gastric perforation during endoscopic submucosal dissection

• Published in: World journal of gastroenterology : WJG 2012-08, Vol.18 (31), p.4224-4227
• Main Authors: Sekiguchi, Masau, Suzuki, Haruhisa, Oda, Ichiro, Yoshinaga, Shigetaka, Nonaka, Satoru, Saka, Makoto, Katai, Hitoshi, Taniguchi, Hirokazu, Kushima, Ryoji, Saito, Yutaka
• Format: Article
• Language: English
• Subjects: Adenocarcinoma - surgery; Aged, 80 and over; Case Report; Endoscopy - adverse effects; Equipment Failure; ESD; Gastric Mucosa - injuries; Humans; Laparoscopy; Male; Stomach Neoplasms - surgery; Surgical Instruments - adverse effects; Surgical Wound Dehiscence - diagnosis; Surgical Wound Dehiscence - surgery; Treatment Outcome; 保守治疗; 关闭; 内镜; 医疗机构; 层剥离; 胃穿孔; 膜下
• ISSN: 1007-9327; 2219-2840
• DOI: 10.3748/wjg.v18.i31.4224

Gastric perforation is one of the most serious compli- cations that can occur during endoscopic submucosal dissection （ESD）. In terms of the treatment of such perforations, we previously reported that perforations immediately observed and successfully closed with endoclips during endoscopic resection could be man- aged conservatively. We now report the first case in our medical facility of a gastric perforation during ESD that was ineffectively treated conservatively even after successful endoscopic closure. In December 2006, we performed ESD on a recurrent early gastric cancer in an 81-year-old man with a medical history of laparotomy for cholelithiasis. A perforation occurred during ESD that was immediately observed and successfully closed with endoclips so that ESD could be continued resulting in an en-bloc resection. Intensive conservative man- agement was conducted following ESD, however, an endoscopic examination five days after ESD revealed dehiscence of the perforation requiring an emergency laparotomy.