2024 Senior Fellows Program (2nd & 3rd Year) | September 2024-Complication Command: Navigating Endo-Hurdles

Video Transcription

Video Summary

The presenter discusses the complications associated with endoscopic procedures, specifically colonoscopy and endoscopy. They focus on risk factors, prevention, and management of complications. Adverse events can start even before the procedure, including syncopal events during bowel prep. Serious concerns involve life-threatening experiences, hospitalizations, and worsening of comorbidities.<br /><br />The importance of informed consent is emphasized, encouraging physicians to personally discuss risks, alternatives, and the specific procedures with patients. Sedation-related complications are noted to be rare but can occur, especially in older and sicker patients. Colonoscopy complications like perforations, which have morbidity and mortality rates, depend on factors such as patient age, steroid use, and previous surgeries.<br /><br />Prevention includes avoiding pushing against fixed resistance, using smaller scopes, and limiting air insufflation. Bleeding is managed by multiple techniques, while abdominal pain and post-polypectomy syndrome are also discussed. Splenic injuries and missed lesions are notable rare but serious complications.<br /><br />For EGD, risks include perforations, especially with dilations, and management strategies are discussed. ERCP-related complications such as pancreatitis are addressed with prevention strategies like indomethacin use and hydration.<br /><br />The presentation concludes with guidance on professional liability and the emotional impact on healthcare providers following complications, suggesting that communication and documentation are key in both prevention and litigation scenarios.

Asset Subtitle

Tian Gao, MD

Keywords

endoscopic procedures

colonoscopy complications

informed consent

sedation risks

perforations

bleeding management

ERCP pancreatitis