Int J Gastrointest Interv 2019; 8(1): 59-61  https://doi.org/10.18528/ijgii190004
Iatrogenic pyriform sinus perforation during endoscopic ultrasonography
Young Min Kim, Jae Jun Park* , and Young Hoon Youn*
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea. E-mail address: dryoun@yuhs.ac (Y.H. Youn). ORCID: https://orcid.org/0000-0002-0071-229X
Department of Internal Medicine, Gangnam Severance Hospital, Yonsei University College of Medicine, 211 Eonju-ro, Gangnam-gu, Seoul 06273, Korea. E-mail address: jaejpark@yuhs.ac (J.J. Park). ORCID: https://orcid.org/0000-0001-9974-1658
Received: January 23, 2019; Revised: January 25, 2019; Accepted: January 25, 2019; Published online: January 31, 2019.
© Society of Gastrointestinal Intervention. All rights reserved.

cc This is an open-access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted noncommercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Abstract
Summary of Event: A 65-year-old women underwent endoscopic ultrasonography (EUS) to evaluate the gastric submucosal tumor. The EUS scope was inserted into the esophagus after two attempts. A neck computed tomography (CT) scan showed a pneumomediastinum and an air bubble deep in the neck, suggesting an esophageal rupture. The patient was hospitalized and maintained conservative treatment including broad-spectrum antibiotics and withholding oral feeding.
Teaching Point: Endoscopists should consider an imaging modality when a patient complains of moderate to severe neck pain after an upper endoscopy. Prompt surgical management should be considered in patients with a delayed diagnosis (> 24 hours), those with signs of systemic toxicity, and those who have eaten between the time of the procedure and when the perforation was detected.
Keywords: Endoscopic ultrasonography; Iatrogenic perforation; Pyriform sinus


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