ASGE Esophagology: Tailoring Management from Testing to Treatment (Live and Virtual) | July 2022-Kothari

Kothari_Managing esophageal complications

Pdf Summary

The content discusses the management of esophageal complications in endoscopy procedures. The author emphasizes the importance of staying calm, anticipating complications, and early identification and intervention during procedures. The document outlines major complications such as bleeding, perforation, and fistula, and provides tips and techniques to manage them.<br /><br />Bleeding is rare but can occur during interventions, in patients on anticoagulation, or due to underlying conditions. The document suggests resuscitation techniques, such as IV access, crystalloids, and blood transfusions if necessary. Hemostatic modalities like thermal therapy, mechanical therapy, and hemostatic spray are recommended for bleeding control.<br /><br />Perforation is a serious complication, and the risk increases with the invasiveness of the procedure. Various endoscopic closure devices, such as endoclips, Over The Scope Clip (OTSC), and fully covered self-expanding metal stents, are discussed for perforation management. The document also mentions endoscopic suturing as an effective technique for closure.<br /><br />Fistula management involves addressing malignant or prolonged ventilation-related fistulas. The options include fully covered self-expanding metal stents, OTSC, degradable stents, Amplatzer devices, endobronchial valves, and mesenchymal stem cell transplantation. The success rates and high recurrence rates are mentioned.<br /><br />The author highlights the importance of appropriate indications, informed consent, infrastructure, and teamwork in preventing and managing complications. Constant communication with patients, families, and the healthcare team is also emphasized.<br /><br />Overall, the content provides a comprehensive overview of common esophageal complications in endoscopy procedures and offers practical management tips and techniques to address them effectively.

Keywords

esophageal complications

endoscopy procedures

management

calm

complication anticipation

early identification

intervention

bleeding

perforation

fistula