Percutaneous needle decompression for tension pneumoperitoneum during GI endoscopy: a step-by-step guide

Area of Science:

• Gastroenterology
• Endoscopic Surgery

Background:

• Gastrointestinal (GI) tract perforations during endoscopy can cause tension pneumoperitoneum, a life-threatening condition.
• Intraprocedural percutaneous needle decompression offers a critical intervention for managing this complication.

Purpose of the Study:

• To review indications for percutaneous needle decompression in endoscopy-related perforations.
• To provide a procedural guide for this technique.

Main Methods:

• A review article format was used.
• A step-by-step procedural guide was developed.
• Two case examples illustrating the technique were presented.

Main Results:

• Intraprocedural needle decompression led to rapid hemodynamic normalization in both cases.
• The technique allowed for safe completion of endoscopic procedures after perforation closure.

Conclusions:

• Early recognition and percutaneous needle decompression are vital for managing endoscopy-related pneumoperitoneum.
• This technique can facilitate defect closure, procedure completion, or serve as a temporizing measure before surgery.
• Endoscopists should be proficient in performing this life-saving intervention.