Korean J Gastroenterol.  2019 Jun;73(6):315-321. 10.4166/kjg.2019.73.6.315.

Medical Dispute Related to Gastrointestinal Endoscopy Complications: Prevention and Management

• Jung Y

• KMID: 2454091
• DOI: http://doi.org/10.4166/kjg.2019.73.6.315

Abstract

Because gastrointestinal (GI) endoscopy examinations are being performed increasingly frequently, the rate of detection of cancer and of precancerous lesions has increased. Moreover, development of more advanced endoscopic technologies has expanded the indications for, and thus frequency of, therapeutic endoscopic procedures. However, the incidence of complications associated with diagnostic or therapeutic GI endoscopy has also increased. The complications associated with GI endoscopy can be ameliorated by endoscopic or conservative treatment, but caution is needed as some of the more serious complications, such as perforation, can lead to death. In this chapter, we review the possible complications of GI endoscopy and discuss methods for their prevention and treatment.

Keyword

Endoscopy; Therapeutics

MeSH Terms

Dissent and Disputes*
Endoscopy
Endoscopy, Gastrointestinal*
Incidence

Reference

1. Hayashi T, Asahina Y, Waseda Y, et al. Lidocaine spray alone is similar to spray plus viscous solution for pharyngeal observation during transoral endoscopy: a clinical randomized trial. Endosc Int Open. 2017; 5:E47–E53.

2. Smith JL, Opekun A, Graham DY. Controlled comparison of topical anesthetic agents in flexible upper gastrointestinal endoscopy. Gastrointest Endosc. 1985; 31:255–258.

3. Zimmerman J, Rachmilewitz D. Systemic anaphylactic reaction following lidocaine administration. Gastrointest Endosc. 1985; 31:404–405.

4. Patel D, Chopra S, Berman MD. Serious systemic toxicity resulting from use of tetracaine for pharyngeal anesthesia in upper endoscopic procedures. Dig Dis Sci. 1989; 34:882–884.

5. Collins JF. Methemoglobinemia as a complication of 20% benzocaine spray for endoscopy. Gastroenterology. 1990; 98:211–213.

6. Isenberg G. Topical anesthesia: to use or not to use-that is the question. Gastrointest Endosc. 2001; 53:130–133.

7. Umegaki E, Abe S, Tokioka S, et al. Risk management for gastrointestinal endoscopy in elderly patients: questionnaire for patients undergoing gastrointestinal endoscopy. J Clin Biochem Nutr. 2010; 46:73–80.

8. Sugase T, Nonaka K, Yoshida T, et al. Comparison of the changes in plasma human growth hormone (HGH) and immuno-reactive glucagon (IRG) after intravenous and subcutaneous injection of glucagon. Endocrinol Jpn. 1976; 23:187–193.

9. DiPalma JA, Brady CE 3rd. Colon cleansing for diagnostic and surgical procedures: polyethylene glycol-electrolyte lavage solution. Am J Gastroenterol. 1989; 84:1008–1016.

10. Marschall HU, Bartels F. Life-threatening complications of nasogastric administration of polyethylene glycol-electrolyte solutions (Golytely) for bowel cleansing. Gastrointest Endosc. 1998; 47:408–410.

11. Santoro MJ, Chen YK, Collen MJ. Polyethylene glycol electrolyte lavage solution-induced Mallory-Weiss tears. Am J Gastroenterol. 1993; 88:1292–1293.

12. Hur GY, Lee SY, Shim JJ, In KH, Kang KH, Yoo SH. Aspiration pneumonia due to polyethylene glycol-electrolyte solution (Golytely) treated by bronchoalveolar lavage. Respirology. 2008; 13:152–154.

13. Heher EC, Thier SO, Rennke H, Humphreys BD. Adverse renal and metabolic effects associated with oral sodium phosphate bowel preparation. Clin J Am Soc Nephrol. 2008; 3:1494–1503.

14. Curran MP, Plosker GL. Oral sodium phosphate solution: a review of its use as a colorectal cleanser. Drugs. 2004; 64:1697–1714.

15. Kontani M, Hara A, Ohta S, Ikeda T. Hypermagnesemia induced by massive cathartic ingestion in an elderly woman without pre-existing renal dysfunction. Intern Med. 2005; 44:448–452.

16. Schelling JR. Fatal hypermagnesemia. Clin Nephrol. 2000; 53:61–65.

17. Kanto JH. Midazolam: the first water-soluble benzodiazepine. Pharmacology, pharmacokinetics and efficacy in insomnia and anesthesia. Pharmacotherapy. 1985; 5:138–155.

18. Doyle WL, Perrin L. Emergence delirium in a child given oral midazolam for conscious sedation. Ann Emerg Med. 1994; 24:1173–1175.

19. Yoo YC. Issues in procedural sedation outside the operating theater: characteristics and safety of commonly used sedatives and analgesics. J Korean Med Assoc. 2013; 56:285–291.

20. Riphaus A, Stergiou N, Wehrmann T. Sedation with propofol for routine ERCP in high-risk octogenarians: a randomized, controlled study. Am J Gastroenterol. 2005; 100:1957–1963.

21. Hertzog JH, Campbell JK, Dalton HJ, Hauser GJ. Propofol anesthesia for invasive procedures in ambulatory and hospitalized children: experience in the pediatric intensive care unit. Pediatrics. 1999; 103:E30.

22. Amornyotin S. Sedation-related complications in gastrointestinal endoscopy. World J Gastrointest Endosc. 2013; 5:527–533.

23. Faigel DO, Baron TH, Goldstein JL, et al. Guidelines for the use of deep sedation and anesthesia for GI endoscopy. Gastrointest Endosc. 2002; 56:613–617.

24. Asge Standards of Practice Committee. Banerjee S, Shen B, et al. Infection control during GI endoscopy. Gastrointest Endosc. 2008; 67:781–790.

25. Bajolet O, Ciocan D, Vallet C, et al. Gastroscopy-associated transmission of extended-spectrum beta-lactamase-producing Pseudomonas aeruginosa. J Hosp Infect. 2013; 83:341–343.

26. ASGE Standards of Practice Committee. Khashab MA, Chithadi KV, et al. Antibiotic prophylaxis for GI endoscopy. Gastrointest Endosc. 2015; 81:81–89.

27. Nelson DB. Infectious disease complications of GI endoscopy: part II, exogenous infections. Gastrointest Endosc. 2003; 57:695–711.

28. Daneshmend TK, Bell GD, Logan RF. Sedation for upper gastrointestinal endoscopy: results of a nationwide survey. Gut. 1991; 32:12–15.

29. Quine MA, Bell GD, McCloy RF, Charlton JE, Devlin HB, Hopkins A. Prospective audit of upper gastrointestinal endoscopy in two regions of England: safety, staffing, and sedation methods. Gut. 1995; 36:462–467.

30. Kavic SM, Basson MD. Complications of endoscopy. Am J Surg. 2001; 181:319–332.

31. American Society of Anesthesiologists Committee. Practice guidelines for preoperative fasting and the use of pharmacologic agents to reduce the risk of pulmonary aspiration: application to healthy patients undergoing elective procedures: an updated report by the American Society of Anesthesiologists Committee on Standards and Practice Parameters. Anesthesiology. 2011; 114:495–511.

32. Montalvo RD, Lee M. Retrospective analysis of iatrogenic Mallory-Weiss tears occurring during upper gastrointestinal endoscopy. Hepatogastroenterology. 1996; 43:174–177.

33. Vu CK, Korman MG, Bejer I, Davis S. Gastrointestinal bleeding after cold biopsy. Am J Gastroenterol. 1998; 93:1141–1143.

34. Sarkis F, Abu Daya H, Sharara A, Soweid A, Barada K. Delayed overt gastrointestinal bleeding after cold endoscopic biopsy. Endoscopy. 2013; 45:75.

35. ASGE Standards of Practice Committee. Ben-Menachem T, Decker GA, et al. Adverse events of upper GI endoscopy. Gastrointest Endosc. 2012; 76:707–718.

36. Park YM, Cho E, Kang HY, Kim JM. The effectiveness and safety of endoscopic submucosal dissection compared with endoscopic mucosal resection for early gastric cancer: a systematic review and metaanalysis. Surg Endosc. 2011; 25:2666–2677.

37. Zhao Y, Wang C. Long-term clinical efficacy and perioperative safety of endoscopic submucosal dissection versus endoscopic mucosal resection for early gastric cancer: an updated meta-analysis. Biomed Res Int. 2018; 2018:3152346.

38. Thirumurthi S, Raju GS. Management of polypectomy complications. Gastrointest Endosc Clin N Am. 2015; 25:335–357.

39. Singaram C, Torbey CF, Jacoby RF. Delayed postpolypectomy bleeding. Am J Gastroenterol. 1995; 90:146–147.

40. Reumkens A, Rondagh EJ, Bakker CM, Winkens B, Masclee AA, Sanduleanu S. Post-colonoscopy complications: a systematic review, time trends, and meta-analysis of population-based studies. Am J Gastroenterol. 2016; 111:1092–1101.

41. Akintoye E, Kumar N, Aihara H, Nas H, Thompson CC. Colorectal endoscopic submucosal dissection: a systematic review and meta-analysis. Endosc Int Open. 2016; 4:E1030–E1044.

42. Kim HS, Kim TI, Kim WH, et al. Risk factors for immediate postpolypectomy bleeding of the colon: a multicenter study. Am J Gastroenterol. 2006; 101:1333–1341.

43. Jaruvongvanich V, Prasitlumkum N, Assavapongpaiboon B, Suchartlikitwong S, Sanguankeo A, Upala S. Risk factors for delayed colonic post-polypectomy bleeding: a systematic review and meta-analysis. Int J Colorectal Dis. 2017; 32:1399–1406.

44. Binmoeller KF, Thonke F, Soehendra N. Endoscopic hemoclip treatment for gastrointestinal bleeding. Endoscopy. 1993; 25:167–170.

45. Lee SH, Chung IK, Kim SJ, et al. Comparison of postpolypectomy bleeding between epinephrine and saline submucosal injection for large colon polyps by conventional polypectomy: a prospective randomized, multicenter study. World J Gastroenterol. 2007; 13:2973–2977.

46. Dobrowolski S, Dobosz M, Babicki A, Dymecki D, Hać S. Prophylactic submucosal saline-adrenaline injection in colonoscopic polypectomy: prospective randomized study. Surg Endosc. 2004; 18:990–993.

47. Di Giorgio P, De Luca L, Calcagno G, Rivellini G, Mandato M, De Luca B. Detachable snare versus epinephrine injection in the prevention of postpolypectomy bleeding: a randomized and controlled study. Endoscopy. 2004; 36:860–863.

48. Guo HM, Zhang XQ, Chen M, Huang SL, Zou XP. Endoscopic submucosal dissection vs endoscopic mucosal resection for superficial esophageal cancer. World J Gastroenterol. 2014; 20:5540–5547.

49. Avgerinos DV, Llaguna OH, Lo AY, Leitman IM. Evolving management of colonoscopic perforations. J Gastrointest Surg. 2008; 12:1783–1789.

50. Jovanovic I, Zimmermann L, Fry LC, Mönkemüller K. Feasibility of endoscopic closure of an iatrogenic colon perforation occurring during colonoscopy. Gastrointest Endosc. 2011; 73:550–555.

51. Cotton PB, Eisen GM, Aabakken L, et al. A lexicon for endoscopic adverse events: report of an ASGE workshop. Gastrointest Endosc. 2010; 71:446–454.

52. Panteris V, Haringsma J, Kuipers EJ. Colonoscopy perforation rate, mechanisms and outcome: from diagnostic to therapeutic colonoscopy. Endoscopy. 2009; 41:941–951.

53. Wada Y, Kudo SE, Tanaka S, et al. Predictive factors for complications in endoscopic resection of large colorectal lesions: a multicenter prospective study. Surg Endosc. 2015; 29:1216–1222.

54. Rutter MD, Nickerson C, Rees CJ, Patnick J, Blanks RG. Risk factors for adverse events related to polypectomy in the English bowel cancer screening programme. Endoscopy. 2014; 46:90–97.

55. Lee EJ, Lee JB, Choi YS, et al. Clinical risk factors for perforation during endoscopic submucosal dissection (ESD) for large-sized, nonpedunculated colorectal tumors. Surg Endosc. 2012; 26:1587–1594.

56. Kim ES, Cho KB, Park KS, et al. Factors predictive of perforation during endoscopic submucosal dissection for the treatment of colorectal tumors. Endoscopy. 2011; 43:573–578.

57. Iqbal CW, Chun YS, Farley DR. Colonoscopic perforations: a retrospective review. J Gastrointest Surg. 2005; 9:1229–1235. discussion 1236.

58. Cobb WS, Heniford BT, Sigmon LB, et al. Colonoscopic perforations: incidence, management, and outcomes. Am Surg. 2004; 70:750–757. discussion 757–758.

59. Anderson ML, Pasha TM, Leighton JA. Endoscopic perforation of the colon: lessons from a 10-year study. Am J Gastroenterol. 2000; 95:3418–3422.

60. 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.

61. Magdeburg R, Collet P, Post S, Kaehler G. Endoclipping of iatrogenic colonic perforation to avoid surgery. Surg Endosc. 2008; 22:1500–1504.

62. Magdeburg R, Sold M, Post S, Kaehler G. Differences in the endoscopic closure of colonic perforation due to diagnostic or therapeutic colonoscopy. Scand J Gastroenterol. 2013; 48:862–867.

63. Kobara H, Mori H, Nishiyama N, et al. Over-the-scope clip system: a review of 1517 cases over 9 years. J Gastroenterol Hepatol. 2019; 34:22–30.

64. Han JH, Park S, Youn S. Endoscopic closure of colon perforation with band ligation; salvage technique after endoclip failure. Clin Gastroenterol Hepatol. 2011; 9:e54–e55.

65. Katsinelos P, Kountouras J, Chatzimavroudis G, et al. Endoscopic closure of a large iatrogenic rectal perforation using endoloop/clips technique. Acta Gastroenterol Belg. 2009; 72:357–359.

66. Raju GS. Endoscopic closure of gastrointestinal leaks. Am J Gastroenterol. 2009; 104:1315–1320.

67. Cho SB, Lee WS, Joo YE, et al. Therapeutic options for iatrogenic colon perforation: feasibility of endoscopic clip closure and predictors of the need for early surgery. Surg Endosc. 2012; 26:473–479.

68. Taku K, Sano Y, Fu KI, et al. Iatrogenic perforation associated with therapeutic colonoscopy: a multicenter study in Japan. J Gastroenterol Hepatol. 2007; 22:1409–1414.