OVER THE SCOPE CLİP (OTSC) İLE BAŞARISIZ KOLON PERFORASYONU KAPATMA GİRİŞİMİ: OLGU SUNUMU
Küçük Resim Yok
Tarih
2020
Yazarlar
Dergi Başlığı
Dergi ISSN
Cilt Başlığı
Yayıncı
Türk Gastroenteroloji Vakfı
Erişim Hakkı
info:eu-repo/semantics/openAccess
Özet
Giriş: Kolonoskopik perforasyon, alt gastrointestinal sistem görüntülemeleri sırasında görülebilecek en ciddi komplikasyonlardan bir tanesidir. Gastrointestinal sistem perforasyonu, hava kaçağına, gastrik veya intestinal sıvıların sızmasına, safra veya gaitanın batın içine sızması ile peritonit, pnömoperitonyum ve sepsis gibi ciddi durumlara neden olabilir. İatrojenik perforasyon yönetimi ve güvenli endoskopik kapatma teknikleri büyük ilgi görmektedir. Gastrointestinal perforasyonlarının kapatılması için over the scope clips (OTSC)'lerin through the scope clips(TTS)’e göre üstün olduğu bildirilmektedir. Biz bu yazıda sigmoid kolon perforasyonu nedeni ile OTSC uygulanan ancak başarısız olması nedeni ile TTS ile onarım sağlanan vakamızı sunmayı amaçladık.Olgu: 73 yaş kadın hastada kolonoskopi işlemi sırasında sigmoid kolon ortalarında kolonoskopi ilişkili perforasyon gelişmesi nedeni ile OTSC uygulandı ve defekt kapatıldı. Ancak birkaç dakika sonra yapılan kontrol kolonoskopide OTSC klipsin tuttuğu dokuyu bıraktığı görülmesi nedeni ile defekt 5 adet TTS klips ile kapatıldı. Tartışma: OTSC sistemi, gastrointestinal kanama, perforasyon, anastomoz kaçağı ve fistül tedavisinde başarıyla kullanılabilen yeni bir tekniktir. OTSC ile genel başarı oranının, iatrojenik gastrointestinal perforasyonların kapatılmasında % 75 ila % 100 arasında olduğu bildirilmekle beraber, başarılı OTSC uygulaması sonrası erken dönemde doku gerilimine bağlı olarak klipsin dokuyu bırakabileceği akılda tutulmalıdır.
İntroduction: Colonoscopic perforation is one of the most serious complications during lower gastrointestinal system imaging. Perforation of the gastrointestinal tract can lead to air leakage, leakage of gastric or intestinal fluids, leakage of bile or feces into the abdomen, and serious conditions such as peritonitis, pneumoperitonium and sepsis. Iatrogenic perforation management and safe endoscopic closure techniques are of great interest. The superiority of over the scope clips(OTSC) over through the scope clips (TTS) for closure of gastrointestinal perforations has been reported.In this article, we aimed to present our case who underwent OTSC for sigmoid colon perforation but failed to repair with 5 TTS clip.Case Report: A 73-year-old female patient underwent OTSC because of colonoscopy-related perforation in the middle of the sigmoid colon during the colonoscopy procedure and the defect was closed. However, after 5 minutes, the control colonoscopy revealed that the OTSC clip was releasing the tissue retained and the defect was closed with conventional clips (TTS). Discussion: The OTSC system is a novel technique that can be used successfully in the treatment of gastrointestinal bleeding, perforation, anastomotic leakage and fistula. Although the overall success rate with OTSC is reported to be between 75% and 100% in the closure of iatrogenic gastrointestinal perforations, it should be kept in mind that after successful OTSC application, the clip may release the tissue due to tissue tension in the early period.
İntroduction: Colonoscopic perforation is one of the most serious complications during lower gastrointestinal system imaging. Perforation of the gastrointestinal tract can lead to air leakage, leakage of gastric or intestinal fluids, leakage of bile or feces into the abdomen, and serious conditions such as peritonitis, pneumoperitonium and sepsis. Iatrogenic perforation management and safe endoscopic closure techniques are of great interest. The superiority of over the scope clips(OTSC) over through the scope clips (TTS) for closure of gastrointestinal perforations has been reported.In this article, we aimed to present our case who underwent OTSC for sigmoid colon perforation but failed to repair with 5 TTS clip.Case Report: A 73-year-old female patient underwent OTSC because of colonoscopy-related perforation in the middle of the sigmoid colon during the colonoscopy procedure and the defect was closed. However, after 5 minutes, the control colonoscopy revealed that the OTSC clip was releasing the tissue retained and the defect was closed with conventional clips (TTS). Discussion: The OTSC system is a novel technique that can be used successfully in the treatment of gastrointestinal bleeding, perforation, anastomotic leakage and fistula. Although the overall success rate with OTSC is reported to be between 75% and 100% in the closure of iatrogenic gastrointestinal perforations, it should be kept in mind that after successful OTSC application, the clip may release the tissue due to tissue tension in the early period.
Açıklama
Anahtar Kelimeler
KOLONOSKOPİ|PERFORASYON|OTSC|TTS|COLONOSCOPY|PERFORATION|OTSC|TTS
Kaynak
Endoskopi Gastrointestinal
WoS Q Değeri
Scopus Q Değeri
Cilt
28
Sayı
1
