Perforation and Bleeding

Although perforation and bleeding from gastroscopy are the complications that patients fear the most, they account for less than 10% of all complications in diagnostic endoscopy.

The most common sites of perforation, in descending order of frequency, are the esophagus, hypopharynx, duodenum, and

Fig. 1.3 Perforation and bleeding. Predisposing factors

Zenker diverticulum

Spondylosis Carcinoma Esophageal varices

Megaesophagus

Nearby malignancies: liver, pancreas

Ulcers And:

endoscopic procedures

Fig. 1.3 Perforation and bleeding. Predisposing factors

Table 1.3 Endoscopically induced infection: risk factors

Transmission of infectious organisms

► From the previously examined patient

► Endogenous transmission (bacteremia)

► Contaminated endoscope stomach. Predisposing factors are diverticula, severe cervical spondylosis, and endoscopic interventions such as dilation, prosthesis insertion, and laser therapy (Fig. 1.3). Severe postbi-opsy bleeding during or after endoscopy is rare.

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