Tiankanon Kasenee, Ngamruengphong Saowanee
Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, USA.
Division of Gastroenterology, Department of Medicine, King Chulalongkorn Memorial Hospital and Chulalongkorn University, Bangkok, Thailand.
Curr Opin Gastroenterol. 2025 Sep 1;41(5):319-326. doi: 10.1097/MOG.0000000000001114. Epub 2025 Jun 4.
Acute endoscopic gastrointestinal perforation, a rare but potentially life-threatening complication of endoscopic procedures, presents a significant management challenge. While surgical repair has been the traditional approach, endoscopic closure offers a highly successful, less invasive alternative in select cases.
Successful endoscopic management hinges on prompt perforation detection, the early initiation of appropriate antibiotic therapy, and the achievement of a secure and adequate endoscopic closure utilizing well honed technical skills. We comprehensively review various endoscopic closure techniques, including standard through-the-scope clips, over-the-scope clips, dual-action clips, Mantis clips, the Overstitch system, endoscopic through-the-scope suturing systems, and the use of covered metal stents.
This review aims to equip gastroenterologists with a practical framework for the timely and effective management of acute endoscopic gastrointestinal perforations.
