- 期刊
Mallory-Weiss Tears Occurring During Upper Gastrointestinal Endoscopy Under Procedural Deep Sedation in a Health Examination Unit-A Case Report
摘要
The incidence of iatrogenic Mallory-Weiss tears occurring during upper gastrointestinal endoscopy has increased with advances in and expansion of use of endoscopic examination. Endoscopic examination under procedural sedation is considered more comfortable for patients, and an endoscopist can perform the examination more smoothly and lessen the possibility of straining or retching. But in patients with obstructive sleep apnea, deep sedation may raise the risk of respiratory compromise and increase the load on the inspiratory muscles (mainly the diaphragm). In addition, the intra-abdominal pressure increases due to insufflation during an endoscopic examination. Thus, patients with obstructive sleep apnea may be more susceptible to Mallory-Weiss tears. Despite the benign course of most Mallory-Weiss tears, hemoclipping is easy to perform and has a high success rate and a low complication rate for hemostasis, offering a rescue method for iatrogenic Mallory-Weiss tears.