GI内镜下张力性气腹的经皮针减压：一步一步的指导

Q3 Medicine

VideoGIE Pub Date : 2025-01-01 DOI:10.1016/j.vgie.2024.09.003

Natalie J. Wilson MD , Rahul Karna MD , Giovanni A. Roldan MD , Roberto Osorio Cintron RN , Alexander Leaf RN , Daniela Guerrero Vinsard MD , Mohammad Bilal MD

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引用次数: 0

摘要

背景和目的内镜检查时胃肠道穿孔可导致严重的不良事件，如紧张性气腹。在这种情况下，术中经皮穿刺减压可以是一种挽救生命的技术，除了允许手术完成。本研究的目的是回顾经皮穿刺减压的适应症，并提供一个循序渐进的手术指导。方法本文回顾了内镜相关穿孔中经皮气腹针减压技术，并结合2例病例给出了一步一步的操作指导。结果两例病例中，术中针头减压使血流动力学迅速恢复正常，并为内镜下缝合穿孔后安全完成手术提供了时间。结论早期识别气腹，术中经皮穿刺大口径导管减压，可为缺陷闭合和手术完成留出时间，或可作为手术干预前的临时措施。内窥镜医师在内窥镜相关穿孔和/或气腹的病例中应该能够自如地使用这种救命技术。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Percutaneous needle decompression for tension pneumoperitoneum during GI endoscopy: a step-by-step guide

Background and Aims

GI tract perforations during endoscopy can lead to serious adverse events such as tension pneumoperitoneum. In such cases, intraprocedural percutaneous needle decompression can be a lifesaving technique, in addition to allowing procedure completion. The aim of this study is to review the indications for percutaneous needle decompression and provide a step-by-step procedural guide with case examples.

Methods

This review article and accompanying video review the technique for percutaneous needle decompression for pneumoperitoneum during endoscopy-related perforation, providing a step-by-step procedural guide illustrated with 2 case examples.

Results

In both case examples, intraprocedural needle decompression resulted in rapid normalization of hemodynamics and allowed time to safely complete the procedures after endoscopic closure of the perforation.

Conclusions

Early recognition of pneumoperitoneum followed by intraprocedural percutaneous needle decompression with a large-bore catheter can allow time for defect closure and procedure completion or can serve as a temporizing measure until surgical intervention. Endoscopists should be comfortable performing this lifesaving technique in cases of endoscopy-related perforation and/or pneumoperitoneum.

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来源期刊

VideoGIE Medicine-Gastroenterology

CiteScore

1.50

自引率

0.00%

发文量

132

审稿时长

105 days

期刊介绍： VideoGIE, an official video journal of the American Society for Gastrointestinal Endoscopy, is an Open Access, online-only journal to serve patients with digestive diseases. VideoGIE publishes original, single-blinded peer-reviewed video case reports and case series of endoscopic procedures used in the study, diagnosis, and treatment of digestive diseases. Videos demonstrate use of endoscopic systems, devices, and techniques; report outcomes of endoscopic interventions; and educate physicians and patients about gastrointestinal endoscopy. VideoGIE serves the educational needs of endoscopists in training as well as advanced endoscopists, endoscopy staff and industry, and patients. VideoGIE brings video commentaries from experts, legends, committees, and leadership of the society. Careful adherence to submission guidelines will avoid unnecessary delays, as incomplete submissions may be returned to the authors before initiation of the peer review process.