ABCs of Endoscopic Perforation Management
A - Air by itself, not an adverse event. Control insufflation, ALWAYS use CO2 and if tension → Drain/Vent
A - Antibiotics (broad spectrum)
B - Bed position using gravity to minimize soilage
C - Closure + Check (contrast study)
D - Diversion of luminal contents (NPO+NGT and/or STENT)
E - Evacuate collections (IR drains)
F - Feeding/nutrition if prolonged NPO status → consider NJT
F - Follow with CT/UGI and serial exams/WBC/CRP etc → Surgery
- Gross soilage
- Persistent contrast extravasation/failed closure
- Sepsis
#ABCs #endosopy #endoscopic #perforation #management #treatment #gastroenterology
