{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T13:08:55Z","timestamp":1787317735477,"version":"build-2736575974"},"reference-count":14,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,12,1]],"date-time":"2019-12-01T00:00:00Z","timestamp":1575158400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T00:00:00Z","timestamp":1576454400000},"content-version":"vor","delay-in-days":15,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Gastroenterol"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Upper gastrointestinal endoscopic examination is a relatively safe procedure; however, all endoscopic procedures are invasive and are associated with a risk of iatrogenic perforation. To evaluate clinical outcomes of iatrogenic upper gastrointestinal endoscopic perforation. Factors associated with surgical management or mortality were analyzed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Between November 2008 and November 2018, the medical records of 149,792 upper gastrointestinal endoscopic procedures were evaluated. The mechanisms of perforations were categorized as electrocoagulation-induced or blunt trauma-induced injuries. The incidence and clinical outcomes of iatrogenic perforations based on the types of procedures performed were evaluated.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Iatrogenic endoscopic perforations occurred in 28 cases (0.019%). Iatrogenic perforation-related mortality occurred in 3 patients. The iatrogenic perforation rate based on the types of procedures performed was as follows: diagnostic endoscopy\u2009=\u20090.002%, duodenal endoscopic mucosal resection\u2009=\u20090.9%, esophageal endoscopic submucosal dissection\u2009=\u200910.7%, gastric endoscopic submucosal dissection\u2009=\u20090.2%, endoscopic self-expandable metal stent insertion for malignant esophageal obstruction\u2009=\u20090.1%, duodenoscope-induced injury\u2009=\u20090.02%, endoscopic sphincterotomy\u2009=\u20090.08%, and ampullectomy\u2009=\u20096.8%. All electrocoagulation-induced perforations (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200921) were managed successfully (15 cases of endoscopic closure, 5 cases treated conservatively, and 1 case treated surgically). Three patients died among those with blunt trauma-induced perforations (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u20097). The factors associated with surgical management or mortality were old age, poor performance status (Eastern Cooperative Oncology Group score\u2009\u2265\u20091), advanced malignancy, and blunt trauma.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Most cases of electrocoagulation-induced iatrogenic perforations can be treated using endoscopic clips. If endoscopic closure fails for blunt trauma-induced perforations, prompt surgical management is mandatory.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12876-019-1139-1","type":"journal-article","created":{"date-parts":[[2019,12,16]],"date-time":"2019-12-16T13:03:00Z","timestamp":1576501380000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["Clinical outcomes of iatrogenic upper gastrointestinal endoscopic perforation: a 10-year study"],"prefix":"10.1186","volume":"19","author":[{"given":"Dae Hwan","family":"Kang","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dae Gon","family":"Ryu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8867-3039","authenticated-orcid":false,"given":"Cheol Woong","family":"Choi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyung Wook","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Bum","family":"Park","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Su Jin","family":"Kim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hyeong Seok","family":"Nam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,12,16]]},"reference":[{"issue":"4","key":"1139_CR1","doi-asserted-by":"publisher","first-page":"618","DOI":"10.1016\/j.gie.2015.03.1977","volume":"82","author":"T Verlaan","year":"2015","unstructured":"Verlaan T, Voermans RP, van Berge Henegouwen MI, Bemelman WA, Fockens P. 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