Percutaneous needle decompression for tension pneumoperitoneum during GI endoscopy: a step-by-step guide
Natalie J Wilson1, Rahul Karna2, Giovanni A Roldan2
1Department of Internal Medicine, University of Minnesota, Minneapolis, Minnesota, USA.
Background And Aims:
GI tract perforations during endoscopy can lead to serious adverse events such as tension pneumoperitoneum. In such cases, intraprocedural percutaneous needle decompression can be a lifesaving technique, in addition to allowing procedure completion. The aim of this study is to review the indications for percutaneous needle decompression and provide a step-by-step procedural guide with case examples.
Methods:
This review article and accompanying video review the technique for percutaneous needle decompression for pneumoperitoneum during endoscopy-related perforation, providing a step-by-step procedural guide illustrated with 2 case examples.
Results:
In both case examples, intraprocedural needle decompression resulted in rapid normalization of hemodynamics and allowed time to safely complete the procedures after endoscopic closure of the perforation.
Conclusions:
Early recognition of pneumoperitoneum followed by intraprocedural percutaneous needle decompression with a large-bore catheter can allow time for defect closure and procedure completion or can serve as a temporizing measure until surgical intervention. Endoscopists should be comfortable performing this lifesaving technique in cases of endoscopy-related perforation and/or pneumoperitoneum.
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