Korean J Gastroenterol.  2022 Nov;80(5):221-224. 10.4166/kjg.2022.060.

Gastric Perforation Encountered during Duodenal Stent Insertion

• Ko SW
• So H
• Bang SJ

• KMID: 2536350
• DOI: http://doi.org/10.4166/kjg.2022.060

Abstract

Gastric outlet obstruction is a major symptom in patients with advanced pancreatic cancer. Endoscopic intervention is often challenging in severe strictures because the guidewire cannot pass beyond the stricture. Sometimes, the air itself cannot pass beyond the stricture, which can result in a severely distended stomach. Such a stomach is vulnerable to excessive air insertion or mechanical stress during endoscopic procedures, and endoscopists may encounter a higher rate of complications. Gastric perforation is rare but could be fatal. However, endoscopic management can show a favorable result if the perforation is noticed early. The authors report a case of the perforation of a gastric tear during duodenal stent insertion in a patient with a gastric outlet obstruction.

Keyword

Stomach; Perforation; Duodenum; Stents

Figure

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  Fig. 1 Computed tomography showing gastric outlet obstruction due to duodenal invasion by pancreatic cancer (arrow).

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  Fig. 2 Endoscopic image of the duodenal obstruction.

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  Fig. 3 (A) Endoscopic image of the gastric perforation. (B) Endoclips were used to close the defect.

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  Fig. 4 Radiograph showing pneumoperitoneum (arrow) following clipping.

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  Fig. 5 Endoscopic image of (A) successful duodenal stent insertion at day 10 following perforation repair, and (B) upper gastrointestinal series showing no leakage at the perforation site.

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