Korean J Med.
2004 May;66(5):526-531.
Successful conservative management of perforation in stomach caused by endoscopic mucosal resection (EMR)
- Affiliations
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- 1Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. leejh@smc.samsung.co.kr
Abstract
- The serious complication after endoscopic mucosal resection (EMR) was bleeding and perforation. Most of bleedings could be controlled by endoscopic procedure. However, the strategy of treatment for perforation was not established. A 60-year-old man was admitted to our center for EMR of gastric adenomatous lesion. After EMR, perforation in stomach was detected by peumoperitoneum on plain upright chest X-ray. We treated with conservative management such as withholding of oral intake, administration of broad-spectrum antibiotics, parenteral nutrition and close monitoring. There were no worsening clinical sings of peritoneal inflammation except mild leukocytosis during the in-hospital course. On the third hospital day after EMR, the patient resumed oral intake. The seventh hospital day, he was discharged. Our experience showed that selected small microperforation in stomach after EMR could be treated by not endoscopic procedures or surgical interventions but conservative management.
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