Title Komplikacije u gastrointestinalnoj endoskopiji Title (english) Complications of gastrointestinal endoscopy Author Iva Barišić Mentor Neven Baršić (mentor)Committee member Lucija Virović Jukić (predsjednik povjerenstva)Committee member Jasenka Markeljević (član povjerenstva)Committee member Neven Baršić (član povjerenstva)Granter University of Zagreb Defense date and country 2022-07-15, Croatia Scientific / art field, BIOMEDICINE AND HEALTHCARE Abstract Endoskopske metode gastrointestinalnog sustava uključuju
ezofagogastroduodenoskopiju, kolonoskopiju, perkutanu endoskopsku gastrostomiju
(PEG), endoskopsku retrogradnu kolangiopankreatografiju (ERCP) te endoskopski
ultrazvuk. Ove invazivne metode, koje vizualiziraju pojedine dijelove probavnog sustava,
nose sa sobom određeni rizik pojave neželjenih događaja. S modernizacijom korištenih
uređaja i napretkom ovih tehnika, rizik za pojavu komplikacije znatno se smanjio u odnosu
na početke primjene istih. Priprema pacijenta prije izvođenja pojedinog zahvata izuzetno
je bitna kako bi zahvat bio uspješan, a rizik pojave komplikacije minimalan. Glavne i
najučestalije komplikacije svih endoskopskih zahvata u probavnom sustavu jesu
perforacija i krvarenje. Neovisno o vrsti tehnike, postojeća koagulopatija ili primjena
antikoagulantnih lijekova povećava rizik pojave krvarenja, dok perforaciji pogoduju loša
priprema bolesnika, patološka stanja stijenke probavnog sustava kao i izvođenje
terapijskih zahvata prilikom endoskopije. Ovisno o težini komplikacije i zdravstvenom
stanju pacijenta odabire se modalitet liječenja koji može uključivati primjenu
konzervativne terapije, ponovljene endoskopske tehnike pa sve do hitnog kirurškog
liječenja. Endoskopičari tako moraju imati na umu moguću pojavu uobičajenih
komplikacija, ali i onih iznimno rijetkih i specifično vezanih uz određenu tehniku. Neke od
mogućih specifičnih komplikacija su ozljeda slezene i postpolipektomijski sindrom vezan
uz kolonoskopiju, pojava post ERCP pankreatitisa nakon ERCP-a te „buried bumper“
sindroma uz primjenu PEG-a. Na posljetku, tijekom svih ovih postupaka moguća je i
pojava općih komplikacije poput infektivnih, kardiovaskularnih ali i nuspojava intravenske
sedacije ili anestezije. Temeljita preoperativna obrada pacijenta uz pažljivi monitoring
tijekom zahvata ove bi neželjene događaje trebala svesti na minimum.
Abstract (english) Gastrointestinal endoscopic procedures include esophagogastroduodenoscopy,
colonoscopy, percutaneous endoscopic gastrostomy, endoscopic retrograde
cholangiopancreatography and endoscopic ultrasound. Mentioned invasive methods that
visualize individual parts of the digestive system, carry a certain risk of adverse events.
Using modern devices and more advanced techniques, the risk of complications has
significantly decreased compared to the beginnings of their application. Preparing the
patient before performing a particular procedure is extremely important for the procedure
to be successful, but also to minimize the risk of complications. The main and most
common complications of all gastrointestinal endoscopic procedures are perforation and
bleeding. Regardless of the type of technique, the existing coagulopathy or the use of
anticoagulant drugs increases the risk of bleeding, while perforation is contributed by poor
preoperative preparation, pathology of the wall of the digestive system as well as
performing therapeutic endoscopy procedures. The choice of treatment modalities
depends on the severity of the complication and the health status of the patient. It may
include the use of conservative therapy, repeated endoscopic techniques and in the most
severe conditions, emergency surgery. Endoscopists must thus keep in mind the
possibility of common complications, but also those that are extremely rare and
specifically related to a particular technique. Some of possible specific complications are
splenic injury and post-polypectomy syndrome associated with colonoscopy, the
occurrence of post-ERCP pancreatitis after ERCP and buried bumper syndrome with the
use of PEG. Finally, infectious complications, side effects of intravenous sedation or
anesthesia as well as cardiovascular complications are possible with these invasive
methods as well as any other procedure. Thorough preoperative treatment and careful
monitoring during the procedure should minimize these adverse events.
Keywords
GI endoskopija
endoskopske komplikacije
krvarenje
perforacija
Keywords (english)
GI endoscopy
endoscopic complications
bleeding
perforation
Language croatian URN:NBN urn:nbn:hr:105:021770 Study programme Title: Medicine Type of resource Text File origin Born digital Access conditions Open access Terms of use Created on 2023-01-02 11:04:23
