抄録
Amoung 211, 410 peroral endoscopic examinations reported in a survey of A/S/G/E members, the overall rate of complications was 1.32/1000. The complication rates for esophageal dilation ranged from 4, 25 to 18.4/1000, depending on the technique employed. Major complications included perforation, hemorrhage from biopsy, aspiration, myocardial infarction, cardiac arrest and arrhythmia, and arrhythmia, and respiatory arrest attributed to topical pharyngeal anesthesia or intravenously administered diazepam (Valium). While confirming the prevailing safety of peroral endoscopy and dilation, this survey points up the need for unremitting vigilance. Radiographic examination, when feasible, should precede peroral endoscopy. Any suspicion of perforation requires prompt radiologic investigation using a water-soluble contrast medium. Biopsy at the base of an ulcer is hazardous. Cardiopulmonary resuscitation should be immediately available in the endoscopy room. Pneumatic dilation of the esophagus carries a small but definite risk of rupture which necessitates emergency thoracotomy.
