A dramatic complication of peroral fiberoptic endoscopy

The advent of the flexible fiberoptic gastroscope has revolutionized clinical gastroenterology. The morbidity and mortality rates with flexible fiberoptic endoscopes are comparable to those associated with rigid and semirigid scopes. Insufflation devices are routinely used with flexible fiberoptic scopes. This may lead to complications, differing from those associated with rigid endoscopy. A case involving an insufflation injury to the piriform sinus is presented. The pathophysiology of insufflation injuries and their management are discussed.