Perforation is a known complication of endoscopic resection and has been managed with endoscopic defect closure, antibiotics and close observation. Closure of duodenal perforations are more challenging due to the presence of gastric and pancreaticobiliary secretions. The use of endoluminal vacuum therapy (EVT) to divert flow and aid closure is increasingly prevalent and may avoid high-risk surgery. We describe the use of endoluminal vacuum closure to salvage an iatrogenic duodenal perforation in a 57-year-old male who underwent an endoscopic mucosal resection of a 35-mm polypoid lesion on the posterior wall of the second portion of the duodenum. The endoluminal wound vac successfully controlled leakage and allowed defect closure. EVT is an emerging technique that can effectively manage complicated injuries throughout the GI tract and may allow enhanced recovery by avoiding surgical salvage and its associated morbidity and mortality.
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| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8572086 | PMC |
| http://dx.doi.org/10.1093/jscr/rjab479 | DOI Listing |
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Article Synopsis
- This study examines the use of endoluminal vacuum therapy for managing anastomotic dehiscences after colorectal surgery, focusing on its effectiveness and feasibility.* -
- Fourteen patients were treated, with a notable 57.1% achieving complete resolution of their defects; those with acute dehiscences showed an even higher success rate of 80%.* -
- The treatment was found to be safe, with a low complication rate of only 7%, indicating that endoluminal vacuum therapy is a promising option for addressing large acute colorectal anastomotic issues.*
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