Successful closure of a duodenal perforation caused by endoscopic ultrasound with an over-the-scope clip: a case report and literature review

J Int Med Res. 2023 Feb;51(2):3000605231154655. doi: 10.1177/03000605231154655.

Abstract

Duodenal perforation is a rare but severe complication during endoscopic ultrasound-guided fine needle aspiration (EUS-FNA) and typically requires surgical intervention. With the widespread clinical use of over-the-scope clips (OTSCs), we aimed to evaluate their efficacy and safety for the closure of a duodenal perforation caused by EUS-FNA. A 79-year-old woman underwent EUS-FNA for a suspected low-density nodule in the head of the pancreas. However, duodenal perforation occurred during EUS-FNA. To minimize the patient's pain postoperatively compared with surgical intervention, we used an OTSC to close the perforation immediately and administered drug treatment for 2 weeks. The patient was discharged after complete recovery. OTSC is considered an effective and safe choice for closing a perforation at the upper corner of the duodenal bulb without surgical intervention.

Keywords: Over-the-scope clip; complete recovery; drug therapy; duodenal perforation; endoscopic ultrasonography; fine needle aspiration; surgical intervention.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Aged
  • Duodenum* / surgery
  • Endosonography
  • Female
  • Humans
  • Pancreas
  • Pancreatic Neoplasms*