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. 2023 Jan 20;8(3):100-103.
doi: 10.1016/j.vgie.2022.11.002. eCollection 2023 Mar.

Iatrogenic perforation during lumen-apposing metal stent deployment closed using an over-the-scope stent fixation clip device

Apurva Shrigiriwar  1 , Shruti Mony  1 , Linda Y Zhang  1 , Mouen A Khashab  1
Affiliations

Iatrogenic perforation during lumen-apposing metal stent deployment closed using an over-the-scope stent fixation clip device

Apurva Shrigiriwar et al. VideoGIE. .

Abstract

Video 1Endoscopic closure of an iatrogenic perforation caused during EUS-guided gastrojejunostomy for malignant gastric outlet obstruction treated with an over-the-scope stent fixation clip device.

Keywords: EUS-GJ, EUS-guided gastrojejunostomy; LAMS, lumen-apposing metal stent; OTS, over-the-scope.

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Figures

Figure 1
Figure 1
CT scan of the abdomen and pelvis with contrast showing severe distension of the stomach and the duodenum (yellow arrows).
Figure 2
Figure 2
Endoscopic view of the second part of the duodenum. A, Obstructing mass. B, Tight stricture.
Figure 3
Figure 3
Perforation of the jejunal wall. A, Fluoroscopic image of a small contrast leak (yellow arrow) confirming the presence of a perforation. B, Endoscopic view of a 10-mm full-thickness jejunal wall tear.
Figure 4
Figure 4
Over-the-scope stent fixation clip device.
Figure 5
Figure 5
Endoscopic view of the deployed over-the-scope stent fixation clip at the site of the jejunal tear.
Figure 6
Figure 6
CT scan of the abdomen and pelvis with contrast obtained 2 months postprocedure showing the lumen-apposing metal stent (yellow arrows) and over-the-scope stent fixation clip (red arrow) in appropriate position without any evidence of a leak or perforation.
See this image and copyright information in PMC

References

    1. Khashab M., Alawad A.S., Shin E.J., et al. Enteral stenting versus gastrojejunostomy for palliation of malignant gastric outlet obstruction. Surg Endosc. 2013;27:2068–2075. - PubMed
    1. Boghossian M.B., Funari M.P., De Moura D.T.H., et al. EUS-guided gastroenterostomy versus duodenal stent placement and surgical gastrojejunostomy for the palliation of malignant gastric outlet obstruction: a systematic review and meta-analysis. Langenbecks Arch Surg. 2021;406:1803–1817. - PubMed
    1. Krishnamoorthi R., Bomman S., Benias P., et al. Efficacy and safety of endoscopic duodenal stent versus endoscopic or surgical gastrojejunostomy to treat malignant gastric outlet obstruction: systematic review and meta-analysis. Endosc Int Open. 2022;10:E874–E897. - PMC - PubMed

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