Percutaneous needle decompression for tension pneumoperitoneum during GI endoscopy: a step-by-step guide

Background and Aims: GI tract perforations during endoscopy can lead to serious adverse events such as tension pneumoperitoneum. In such cases, intraprocedural percutaneous needle decompression can be a lifesaving technique, in addition to allowing procedure completion. The aim of this study is to r...

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Bibliographic Details
Main Authors: Natalie J. Wilson, MD, Rahul Karna, MD, Giovanni A. Roldan, MD, Roberto Osorio Cintron, RN, Alexander Leaf, RN, Daniela Guerrero Vinsard, MD, Mohammad Bilal, MD
Format: Article
Language:English
Published: Elsevier 2025-01-01
Series:VideoGIE
Online Access:http://www.sciencedirect.com/science/article/pii/S2468448124001383
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Summary:Background and Aims: GI tract perforations during endoscopy can lead to serious adverse events such as tension pneumoperitoneum. In such cases, intraprocedural percutaneous needle decompression can be a lifesaving technique, in addition to allowing procedure completion. The aim of this study is to review the indications for percutaneous needle decompression and provide a step-by-step procedural guide with case examples. Methods: This review article and accompanying video review the technique for percutaneous needle decompression for pneumoperitoneum during endoscopy-related perforation, providing a step-by-step procedural guide illustrated with 2 case examples. Results: In both case examples, intraprocedural needle decompression resulted in rapid normalization of hemodynamics and allowed time to safely complete the procedures after endoscopic closure of the perforation. Conclusions: Early recognition of pneumoperitoneum followed by intraprocedural percutaneous needle decompression with a large-bore catheter can allow time for defect closure and procedure completion or can serve as a temporizing measure until surgical intervention. Endoscopists should be comfortable performing this lifesaving technique in cases of endoscopy-related perforation and/or pneumoperitoneum.
ISSN:2468-4481