Identification of Iatrogenic Perforation in Pediatric Gastrointestinal Endoscopy.

Humans Child Retrospective Studies Endoscopy, Gastrointestinal / adverse effects Cholangiopancreatography, Endoscopic Retrograde Fluoroscopy Intestinal Perforation / etiology Iatrogenic Disease

Journal

Journal of pediatric gastroenterology and nutrition
ISSN: 1536-4801
Titre abrégé: J Pediatr Gastroenterol Nutr
Pays: United States
ID NLM: 8211545

Informations de publication

Date de publication:
01 09 2023
Historique:
medline: 21 8 2023
pubmed: 5 6 2023
entrez: 5 6 2023
Statut: ppublish

Résumé

Iatrogenic viscus perforation in pediatric gastrointestinal endoscopy (GIE) is a very rare, yet potentially life-threatening event. There are no evidence-based recommendations relating to immediate post-procedure follow-up to identify perforations and allow for timely management. This study aims to characterize the presentation of children with post-GIE perforation to better rationalize post-procedure recommendations. Retrospective study based on unrestricted pooled data from centers throughout Europe, North America, and the Middle East affiliated with the Endoscopy Special Interest Groups of European Society for Paediatric Gastroenterology Hepatology and Nutrition and North American Society for Pediatric Gastroenterology Hepatology and Nutrition. Procedural and patient data relating to clinical presentation of the perforation were recorded on standardized REDCap case-report forms. Fifty-nine cases of viscus perforation were recorded [median age 6 years (interquartile range 3-13)]; 29 of 59 (49%) occurred following esophagogastroduodenoscopy, 26 of 59 (44%) following ileocolonoscopy, with 2 of 59 (3%) cases each following balloon enteroscopy and endoscopic retrograde cholangiopancreatography; 28 of 59 (48%) of perforations were identified during the procedure [26/28 (93%) endoscopically, 2/28 (7%) by fluoroscopy], and a further 5 of 59 (9%) identified within 4 hours. Overall 80% of perforations were identified within 12 hours. Among perforations identified subsequent to the procedure 19 of 31 (61%) presented with pain, 16 of 31 (52%) presented with fever, and 10 of 31 (32%) presented with abdominal rigidity or dyspnea; 30 of 59 (51%) were managed surgically, 17 of 59 (29%) managed conservatively, and 9 of 59 (15%) endoscopically; 4 of 59 (7%) patients died, all following esophageal perforation. Iatrogenic perforation was identified immediately in over half of cases and in 80% of cases within 12 hours. This novel data can be utilized to generate guiding principles of post-procedural follow-up and monitoring. Bowel perforation following pediatric gastrointestinal endoscopy is very rare with no evidence to base post-procedure follow-up for high-risk procedures. We found that half were identified immediately with the large majority identified within 12 hours, mostly due to pain and fever.

Identifiants

DOI: 10.1097/MPG.0000000000003852 PMID: 37276149
pubmed: 37276149
doi: 10.1097/MPG.0000000000003852
pii: 00005176-990000000-00402
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

401-406

Informations de copyright

Copyright © 2023 by European Society for European Society for Pediatric Gastroenterology, Hepatology, and Nutrition and North American Society for Pediatric Gastroenterology, Hepatology, and Nutrition.

Déclaration de conflit d'intérêts

The authors report no conflicts of interest.

Références

Franciosi JP, Fiorino K, Ruchelli E, et al. Changing indications for upper endoscopy in children during a 20-year period. J Pediatr Gastroenterol Nutr 2010;51:443–7. doi:10.1097/MPG.0b013e3181d67bee.
doi: 10.1097/MPG.0b013e3181d67bee
Broekaert I, Tzivinikos C, Narula P, et al. European Society for Paediatric Gastroenterology, Hepatology and Nutrition position paper on training in paediatric endoscopy. J Pediatr Gastroenterol Nutr 2020;70:127–40. doi:10.1097/MPG.0000000000002496.
doi: 10.1097/MPG.0000000000002496
Paspatis GA, Arvanitakis M, Dumonceau JM, et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement – update 2020. Endoscopy 2020;52:792–810. doi:10.1055/a-1222-3191.
doi: 10.1055/a-1222-3191
Baron TH, Wong Kee Song LM, Zielinski MD, Emura F, Fotoohi M, Kozarek RA. A comprehensive approach to the management of acute endoscopic perforations (with videos). Gastrointest Endosc 2012;76:838–59. doi:10.1016/j.gie.2012.04.476.
doi: 10.1016/j.gie.2012.04.476
Kramer RE, Walsh CM, Lerner DG, Fishman DS. Quality improvement in pediatric endoscopy: a clinical report from the NASPGHAN endoscopy committee. J Pediatr Gastroenterol Nutr 2017;65:125–31. doi:10.1097/MPG.0000000000001592.
doi: 10.1097/MPG.0000000000001592
Kramer RE, Narkewicz MR. Adverse events following gastrointestinal endoscopy in children: classifications, characterizations, and implications. J Pediatr Gastroenterol Nutr 2016;62:828–33. doi:10.1097/MPG.0000000000001038.
doi: 10.1097/MPG.0000000000001038
Attard TM, Miller M, Lee B, Champion TW, Thomson M. Pediatric elective diagnostic procedure complications: a multicenter cohort analysis. J Gastroenterol Hepatol 2019;34:147–53. doi:10.1111/jgh.14318.
doi: 10.1111/jgh.14318
Cox CB, Laborda T, Kynes JM, Hiremath G. Evolution in the practice of pediatric endoscopy and sedation. Front Pediatr 2021;9:687635. doi:10.3389/fped.2021.687635.
doi: 10.3389/fped.2021.687635
Quine MA, Bell GD, McCloy RF, Matthews HR. Prospective audit of perforation rates following upper gastrointestinal endoscopy in two regions of England. Br J Surg 1995;82:530–3. doi:10.1002/bjs.1800820430.
doi: 10.1002/bjs.1800820430
Sieg A, Hachmoeller-Eisenbach U, Eisenbach T. Prospective evaluation of complications in outpatient GI endoscopy: a survey among German gastroenterologists. Gastrointest Endosc 2001;53:620–7. doi:10.1067/mge.2001.114422.
doi: 10.1067/mge.2001.114422
Eisen GM, Baron TH, Dominitz JA, et al. Complications of upper GI endoscopy. Gastrointest Endosc 2002;55:784–93. doi:10.1016/s0016-5107(02)70404-5.
doi: 10.1016/s0016-5107(02)70404-5
Korman LY, Overholt BF, Box T, Winker CK. Perforation during colonoscopy in endoscopic ambulatory surgical centers. Gastrointest Endosc 2003;58:554–7. doi:10.1067/s0016-5107(03)01890-x.
doi: 10.1067/s0016-5107(03)01890-x
Dominitz JA, Eisen GM, Baron TH, et al. Complications of colonoscopy. Gastrointest Endosc 2003;57:441–5. doi:10.1016/s0016-5107(03)80005-6.
doi: 10.1016/s0016-5107(03)80005-6
Day LW, Kwon A, Inadomi JM, Walter LC, Somsouk M. Adverse events in older patients undergoing colonoscopy: a systematic review and meta-analysis. Gastrointest Endosc 2011;74:885–96. doi:10.1016/j.gie.2011.06.023.
doi: 10.1016/j.gie.2011.06.023
Hsu EK, Chugh P, Kronman MP, Markowitz JE, Piccoli DA, Mamula P. Incidence of perforation in pediatric GI endoscopy and colonoscopy: an 11-year experience. Gastrointest Endosc 2013;77:960–6. doi:10.1016/j.gie.2012.12.020.
doi: 10.1016/j.gie.2012.12.020
Pouw RE, van Vilsteren FG, Peters FP, et al. Randomized trial on endoscopic resection-cap versus multiband mucosectomy for piecemeal endoscopic resection of early Barrett’s neoplasia. Gastrointest Endosc 2011;74:35–43. doi:10.1016/j.gie.2011.03.1243.
doi: 10.1016/j.gie.2011.03.1243
Holmes I, Friedland S. Endoscopic mucosal resection versus endoscopic submucosal dissection for large polyps: a Western Colonoscopist’s view. Clin Endosc 2016;49:454–6. doi:10.5946/ce.2016.077.
doi: 10.5946/ce.2016.077
ASGE Standards of Practice Committee, Ben-Menachem T, Decker GA, et al. Adverse events of upper GI endoscopy. Gastrointest Endosc 2012;76:707–18. doi:10.1016/j.gie.2012.03.252.
doi: 10.1016/j.gie.2012.03.252
Vermeulen BD, de Zwart M, Sijben J, et al. Risk factors and clinical outcomes of endoscopic dilation in benign esophageal strictures: a long-term follow-up study. Gastrointest Endosc 2020;91:1058–66. doi:10.1016/j.gie.2019.12.040.
doi: 10.1016/j.gie.2019.12.040
Paspatis GA, Dumonceau JM, Barthet M, et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) position statement. Endoscopy 2014;46:693–711. doi:10.1055/s-0034-1377531.
doi: 10.1055/s-0034-1377531
Clark SJ, Staffa SJ, Ngo PD, et al. Rules are meant to be broken: examining the “Rule of 3” for esophageal dilations in pediatric stricture patients. J Pediatr Gastroenterol Nutr 2020;71:e1–5. doi:10.1097/MPG.0000000000002687.
doi: 10.1097/MPG.0000000000002687
Navaneethan U, Lourdusamy V, Njei B, Shen B. Endoscopic balloon dilation in the management of strictures in Crohn’s disease: a systematic review and meta-analysis of non-randomized trials. Surg Endosc 2016;30:5434–43. doi:10.1007/s00464-016-4902-1.
doi: 10.1007/s00464-016-4902-1
Bettenworth D, Mucke MM, Lopez R, et al. Efficacy of endoscopic dilation of gastroduodenal Crohn’s disease strictures: a systematic review and meta-analysis of individual patient data. Clin Gastroenterol Hepatol 2019;17:2514–22.e8. doi:10.1016/j.cgh.2018.11.048.
doi: 10.1016/j.cgh.2018.11.048
Sdralis EIK, Petousis S, Rashid F, Lorenzi B, Charalabopoulos A. Epidemiology, diagnosis, and management of esophageal perforations: systematic review. Dis Esophagus 2017;30:1–6. doi:10.1093/dote/dox013.
doi: 10.1093/dote/dox013
Attard TM, Grima AM, Thomson M. Pediatric endoscopic procedure complications. Curr Gastroenterol Rep 2018;20:48. doi:10.1007/s11894-018-0646-5.
doi: 10.1007/s11894-018-0646-5

Auteurs

Oren Ledder (O)

From Juliet Keidan Institute of Paediatric Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel.
Hebrew University of Jerusalem, Jerusalem, Israel.

Marek Woynarowski (M)

University of Jan Kochanowski, Kielce, Poland.

Diana Kamińska (D)

Children's Memorial Health Institute, Warsaw, Poland.

Izabella Łazowska-Przeorek (I)

Medical University of Warsaw, Warsaw, Poland.

Stanislaw Pieczarkowski (S)

Jagiellonian University Medical College, Krakow, Poland.

Claudio Romano (C)

the Pediatric Gastroenterology and Cystic Fibrosis Unit, Department of Human Pathology in Adulthood and Childhood "G. Barresi", University of Messina, Messina, Italy.

Raffi Lev-Tzion (R)

From Juliet Keidan Institute of Paediatric Gastroenterology, Shaare Zedek Medical Center, Jerusalem, Israel.

Magdalena Holon (M)

Medical University of Silesia, Katowice, Poland.

Andreia Nita (A)

Great Ormond Street Hospital, London, United Kingdom.

Anna Rybak (A)

Great Ormond Street Hospital, London, United Kingdom.

Elżbieta Jarocka-Cyrta (E)

University of Warmia and Mazury, Olsztyn, Poland.

Bartosz Korczowski (B)

the Department of Pediatrics and Pediatric Gastroenterology, Institute of Medical Sciences, Medical College, University of Rzeszów, Rzeszów, Poland.

Elzbieta Czkwianianc (E)

Polish Mother's Memorial Hospital, Lodz, Poland.

Iva Hojsak (I)

Children's Hospital Zagreb, University of Zagreb Medical School, Zagreb, Croatia.

Anna Szaflarska-Popławska (A)

Ludwik Rydygier Collegium Medicum, Bydgoszcz, Poland.

Bruno Hauser (B)

University Hospital Brussels, Brussels, Belgium.

Isabelle Scheers (I)

the Pediatric Gastroenterology and Hepatology Unit, Cliniques Universitaires Saint-Luc, Brussels, Belgium.

Shishu Sharma (S)

Sheffield Children's Hospital, Sheffield, United Kingdom.

Salvatore Oliva (S)

the Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Raoul Furlano (R)

University Children's Hospital, Basel, Switzerland.

Christos Tzivinikos (C)

Al Jalila Children's Specialty Hospital, Dubai, United Arab Emirates.

Quin Y Liu (QY)

Cedars-Sinai Medical Center, Los Angles, CA.

Matthew Giefer (M)

Ochsner Hospital for Children, New Orleans, LA.

Petar Mamula (P)

Children's Hospital of Philadelphia, Philadelphia, PA.

Andrew Grossman (A)

Children's Hospital of Philadelphia, Philadelphia, PA.

Judith Kelsen (J)

Children's Hospital of Philadelphia, Philadelphia, PA.

Brian Edelstein (B)

Sinai Children's Hospital, Chicago, IL.

Matthieu Antoine (M)

Univ. Lille, CHU Lille, Gastroentérologie, Hépatologie et Nutrition Pédiatrique, Hôpital Jeanne de Flandre, Lille, France.

Mike Thomson (M)

the Pediatric Gastroenterology and Liver Unit, Maternal and Child Health Department, Sapienza University of Rome, Rome, Italy.

Matjaž Homan (M)

University Children's Hospital, Medical Faculty, Ljubljana, Slovenia.

Articles similaires

[Redispensing of expensive oral anticancer medicines: a practical application].

Lisanne N van Merendonk, Kübra Akgöl, Bastiaan Nuijen
1.00
Humans Antineoplastic Agents Administration, Oral Drug Costs Counterfeit Drugs

Smoking Cessation and Incident Cardiovascular Disease.

Jun Hwan Cho, Seung Yong Shin, Hoseob Kim et al.
1.00
Humans Male Smoking Cessation Cardiovascular Diseases Female

Evaluation of Low-Value Services Across Major Medicare Advantage Insurers and Traditional Medicare.

Ciara Duggan, Adam L Beckman, Ishani Ganguli et al.
1.00
Humans United States Aged Cross-Sectional Studies Medicare Part C

Effectiveness of Virtual Yoga for Chronic Low Back Pain: A Randomized Clinical Trial.

Hallie Tankha, Devyn Gaskins, Amanda Shallcross et al.
1.00
Humans Yoga Low Back Pain Female Male

Classifications MeSH

questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Personnes › Tranches d'âge › Enfant › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Méthodes épidémiologiques › Caractéristiques des études épidémiologiques › Études épidémiologiques › Études de cohortes › Études rétrospectives › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Endoscopie digestive › Endoscopie gastrointestinale › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Procédures de chirurgie opératoire › Interventions chirurgicales mini-invasives › Endoscopie › Endoscopie digestive › Cholangiopancréatographie rétrograde endoscopique › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Diagnostic › Techniques et procédures diagnostiques › Imagerie diagnostique › Radiographie › Radioscopie › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › Maladies de l'appareil digestif › Maladies gastro-intestinales › Maladies intestinales › Perforation intestinale › Identification of Iatrogenic Perforation in...
questionsmedicales.fr › États, signes et symptômes pathologiques › Processus pathologiques › Caractéristiques de la maladie › Maladie iatrogène › Identification of Iatrogenic Perforation in...