Complications of Upper Gastrointestinal Endoscopy

Chan, Mary F.

doi:10.1016/s1052-5157(18)30364-7

Cited by 57 publications

(25 citation statements)

References 87 publications

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“…In all, 20 deaths directly related to endoscopy were identified by the SASM process of a total of 33,854 upper GI endoscopies performed by surgeons during that year. This is similar to the estimated overall death rate for upper GI endoscopy of one in 1,000-2,000 documented in the literature [5,16]. Clearly, a further 45,000 upper GI endoscopies were performed by physicians in Scotland for whom there is no comparable audit process.…”

Section: Discussionsupporting

confidence: 81%

Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement?

et al. 2004

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Section: Discussionsupporting

confidence: 81%

Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement?

et al. 2004

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“…Thus, the risk of apnea and cardiopulmonary arrest increases with the number of comorbid conditions. Monitoring does not prevent such events, but does assist in early recognition [21].…”

Section: Discussionmentioning

confidence: 99%

Upper and lower gastrointestinal endoscopy mortality: the medical examiner’s perspective

deRoux

Sgarlato

2011

Forensic Sci Med Pathol

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Fiberoptic endoscopy is utilized to diagnose and treat a wide variety of gastrointestinal tract diseases and is currently one of the most commonly performed invasive medical procedures. Though generally considered to be safe, the procedure may be associated with serious complications including death. Herein, we correlate the clinical history with the autopsy findings in gastrointestinal endoscopy (GIE) related fatalities that were reported to the New York City Medical Examiner Office over a 5 year period. The complication rate is higher in therapeutic procedures when compared to diagnostic procedures. Though fatalities following iatrogenic complications are four times more common, emphasis is placed on patients who died following a cardiorespiratory event during or immediately following the procedure. Of 41 upper and 36 lower GIE related fatalities, 10 and 9 respectively, fit this category. The comorbidities frequently associated with fatal cardiorespiratory events were: hypertension and obesity with associated cardiac hypertrophy, diabetes mellitus and coronary artery atherosclerosis. For colonoscopies, the approximate incidence of perforation was 0.00625% and the procedure-related fatality rate was 0.014%. The literature on anesthesia for GIE is also discussed.

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“…It is estimated that there is one complication per 1,000 interventions and between 0.5 and 3 deaths per 10,000 examinations [47]. Whilst these rates appear low, they are proportionally much more important than the potential risk of any delay in making an alternative diagnosis in a patient with typical reflux symptoms [48].…”

Section: Diagnosis and Diagnostic Methodsmentioning

confidence: 99%

Management of Reflux Symptoms with Over-the-Counter Proton Pump Inhibitors: Issues and Proposed Guidelines

Haag¹,

Andrews²,

Katelaris³

et al. 2009

Digestion

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Background: Symptoms of gastroesophageal reflux are widely prevalent. There is a continuum between subjects with mild reflux symptoms and those severely affected by gastroesophageal reflux disease (GERD). Both groups may at times access over-the-counter (OTC) therapies. For the purpose of this review, relevant papers, including national and international guidelines were reviewed and recommendations made for appropriate use of OTC proton pump inhibitor (PPI) therapy. Results: PPIs are the gold standard for treatment of reflux symptoms. OTC therapy with histamine₂ receptor antagonists (H2RAs) also plays a role. For the majority affected by reflux symptoms, effective symptom control is the most important outcome, as only a subgroup requires investigations or interventions. However, patients with alarm features (i.e. troublesome dysphagia, weight loss, predominant upper abdominal pain) are not recommended for OTC therapy and need prompt medical referral. Frequent relapses or failure to adequately respond to OTC therapy are additional triggers for medical assessment. Conclusions: OTC treatment of typical reflux symptoms (acid regurgitation, heartburn) with antacids and H2RAs is now accepted as safe and results in short-term relief of symptoms. There is no evidence of additional risk with OTC PPIs compared to these existing OTC therapies and PPIs are significantly more efficacious.

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Complications of Upper Gastrointestinal Endoscopy

Cited by 57 publications

References 87 publications

Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement?

Analysis of 153 deaths after upper gastrointestinal endoscopy: room for improvement?

Upper and lower gastrointestinal endoscopy mortality: the medical examiner’s perspective

Management of Reflux Symptoms with Over-the-Counter Proton Pump Inhibitors: Issues and Proposed Guidelines

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