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[Nasopharyngeal perforation: an exceptional accident during digestive endoscopy]
P Verron1, G Grandpierre, B Vergeau
1Service ORL et chirurgie cervicofaciale, Hôpital d'Instruction des Armées Begin, Saint-Mandé.
Summary
A rare endoscopic nasopharynx perforation occurred during duodenal tube insertion, leading to widespread air leakage. This previously undescribed complication rapidly progressed, preventing effective treatment in a 92-year-old patient.
Area of Science:
- Gastroenterology
- Endoscopy
- Surgical Complications
Background:
- Endoscopic procedures, while common, carry inherent risks.
- Nasopharyngeal perforation is an exceptionally rare complication during gastrointestinal intubation.
- Accurate diagnosis and prompt management are crucial for patient outcomes.
Observation:
- A 92-year-old patient developed subcutaneous neck emphysema during duodenal tube insertion.
- Radiographic imaging confirmed extensive air leakage, including pneumomediastinum, pneumoperitonitis, and retropneumoperitonitis.
- Nasofibroscopy was utilized to confirm the diagnosis of nasopharyngeal perforation.
Findings:
- This case represents the first documented instance of endoscopic nasopharynx perforation during duodenal tube placement.
- The perforation led to severe extraluminal air dissemination.
- The patient's rapid decline precluded any therapeutic intervention.
Implications:
- Highlights the potential for rare but severe complications during routine endoscopic procedures.
- Emphasizes the need for heightened awareness and vigilance among endoscopists.
- Underscores the importance of early recognition and the challenges in managing such critical events, especially in elderly patients.