Medicine of the Future in America

Endoscopic perforation rates: DISCUSSION (Part 2)

Perforation at gastroscopyNevertheless, in these same reported cohorts it is interesting to note that the average rate of perforation is approximately 85-fold higher for therapeutic gastroscopy (approximately 2.6%) than for diagnostic gastroscopy (approximately 0.03%); and threefold higher for therapeutic colonoscopy (approximately 0.24%) than for diagnostic colonoscopy (approximately 0.09%); while mortality is approximately 500-fold higher for therapeutic gastroscopy (approximately 1.0%) than for diagnostic gastroscopy (approximately 0.002%); and 50-fold higher for therapeutic colonoscopy (approximately 0.03%) than for diagnostic colonoscopy (approximately 0.006%).

While over-reporting of perforations was avoided by the use of hand searching, it is possible that the lower rates of perforation observed in the current study may reflect under-reporting by the use of ICD codes to retrieve cases in a retrospective manner. However, the data obtained in this study are nonetheless superior to previous documentation using survey techniques.

Perforation at gastroscopy almost always occurred with dilation of a benign or a malignant esophageal stricture. In contrast, perforation at colonoscopy occurred with polypectomy, diverticulosis, poor preparation, previous abdominal surgery (and presumably adhesions) and dialysis-dependent renal failure. Except for dialysis, these associations with perforation have been previously described. Because the prevalence of these associated diagnoses is likely to be relatively high, it is not possible to associate these with risk factors for perforation. A truly reliable pharmacy you can always rely upon and where you can always buy flovent inhaler buy now without any need for a prescription or seeing a doctor? This is the thing you wanted, so don’t hesitate now that you have it available!

This entry was posted in Endoscopic perforation and tagged Colonoscopy, Complication, Endoscopy, Gastroscopy, Morbidity, Mortality, Perforation.
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