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Updated: Jul 5, 2026

Guidelines for Elective Pediatric Fiberoptic Intubation
Published on: January 17, 2011
Pediatric endoscopic injuries: incidence, management, and outcomes
Corcy W Iqbal1, Johanna R Askegard-Giesmann, Tuan H Pham
1Division of General and Gastroenterological Surgery, Department of Surgery, Mayo Clinic Rochester, MN 55905, USA.
Background:
Endoscopy has assumed a significant role in the management of gastrointestinal disorders. However, endoscopic-related injuries are poorly reported.
Methods:
Review of our surgical database (1980-2006) identified all patients age 18 years or younger with an endoscopic-related injury managed at our institution.
Results:
A total of 3269 colonoscopies were performed; there were 3 iatrogenic perforations (incidence, 0.09%). All were managed operatively: 2 underwent fecal diversion, and 1 was repaired primarily. There was 1 postoperative complication (internal hernia) and no deaths related to colonoscopic perforation. Nine thousand three hundred eight esophagogastroduodenoscopy (EGD) procedures were performed, resulting in 6 iatrogenic injuries (0.06%): bleeding (2), perforation (2), and mucosal tears (2) (0.02% each). All EGD-related injuries occurred in the esophagus except for 1 duodenal perforation which was managed operatively by primary repair. Both patients with bleeding complications underwent repeat endoscopy and cautery with satisfactory results. The other 3 patients were managed conservatively without complication. Three hundred eighty-nine endoscopic retrograde cholangiopancreatogram procedures were performed with 2 iatrogenic injuries (0.5%): 1 bleed and 1 perforation (0.25% each). Both were managed conservatively without complication.
Conclusion:
Endoscopic injuries are uncommon. Colonoscopic perforations require prompt surgical intervention. Esophagogastroduodenoscopy- and endoscopic retrograde cholangiopancreatogram-related injuries are amenable to conservative therapy in clinically stable patients devoid of peritonitis.
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