A 77-year-old woman was admitted with complaint of anorexia and anemia. We performed diagnostic upper gastrointestinal endoscopy. Features indicative of reflux esophagitis and severe atrophic gastritis were recognized, but hemorrhagic lesions were not observed. During the examination, there were multiple lacerations in the lesser curvature of stomach, immediately halted by the removal of gastric air. Free air was confirmed on abdominal CT image, and a diagnosis of gastric perforation. We decided conservative management because neither fever nor abdominal symptoms and mild inflammatory response. Inflammatory response improved with continued suction via nasogastric intubation, and antimicrobial administration. Abdominal CT taken after 2 weeks showed no free air and confirmed the closure of the perforation in the stomach X-ray contrast examination.
This was a case of gastric perforation resulting from air insuffitation during upper gastrointestinal endoscopy.
