Abstract
Peroral endoscopic myotomy (POEM) is a procedure with potential for serious adverse events. Postprocedure imaging is routinely done, yet there is no consensus on the optimal imaging protocol. We describe a novel and simple CT esophagram protocol for evaluation after POEM and for reporting the full spectrum of radiographic findings and subsequent interventions. This was a single-center prospective study of consecutive patients treated with POEM evaluated with CT esophagram. Eighty-four consecutive patients who had POEM performed underwent CT esophagrams. The most common findings were pneumomediastinum (85.7%), pneumoperitoneum (66.7%), subcutaneous emphysema (52.4%), and pleural effusion (46.4%). Other findings included retroperitoneal air (38.1%), pneumothorax (19%), atelectasis (14.3%), intramural air in the esophagus and/or stomach (13.1%), pericardial effusion (2.4%), and pneumopericardium (2.4%). Five patients required intervention based on CT findings. In 1 patient, a leak was detected on CT esophagram before any clinical manifestation, facilitating prompt intervention and avoiding potential serious outcomes. Four patients were diagnosed with pneumonia and were treated with antibiotics. There was frequent postprocedural at...Continue Reading
References
Aug 1, 1985·Archives of Internal Medicine·M H Mellow, H Pinkas
Aug 21, 2007·Endoscopy·P J PasrichaC J Gostout
Nov 6, 2009·Gastrointestinal Endoscopy·Michelle A AndersonJason A Dominitz
Apr 1, 2010·Endoscopy·H InoueS Kudo
May 1, 2010·Endoscopy·F OnogiH Moriwaki
Oct 15, 2011·Journal of the American College of Surgeons·Lee L SwanströmChristy M Dunst
May 23, 2012·Digestive and Liver Disease : Official Journal of the Italian Society of Gastroenterology and the Italian Association for the Study of the Liver·Guido CostamagnaVincenzo Perri
Oct 10, 2012·Gastrointestinal Endoscopy·Philip Wai Yan ChiuEnders Kwok Wai Ng
Oct 13, 2012·Journal of Thoracic Imaging·Joshua E LantosDrew A Torigian
Mar 5, 2013·Gastrointestinal Endoscopy·Tessa VerlaanPaul Fockens
Apr 4, 2013·Surgical Endoscopy·Stavros N StavropoulosThomas Savides
Apr 16, 2013·Digestive Endoscopy : Official Journal of the Japan Gastroenterological Endoscopy Society·Hitomi MinamiKazuhiko Nakao
Apr 25, 2013·Clinical Endoscopy·Byung Hoo LeeJoo Young Cho
May 15, 2013·Gastroenterology·Daniel Von RentelnThomas Rösch
Nov 28, 2013·Diagnostic and Therapeutic Endoscopy·Dennis Yang, Mihir S Wagh
Apr 1, 2014·Annals of Surgical Oncology·Jonathan Cools-LartigueLorenzo Ferri
Jul 8, 2014·Gastrointestinal Endoscopy·Ming-Yan CaiQuan-Lin Li
Oct 4, 2014·Acta Radiologica·Shan YangXing-Wei Zhang
Jan 31, 2015·Gastrointestinal Endoscopy·Mouen A KhashabHaruhiro Inoue
Feb 28, 2015·Gut and Liver·Quan Lin Li, Ping Hong Zhou
Mar 10, 2015·American Journal of Surgery·Jason BinghamVance Sohn
Jul 25, 2015·Journal of the American College of Surgeons·Haruhiro InoueShin-ei Kudo
Sep 12, 2015·Endoscopy International Open·Dennis YangPeter V Draganov
Citations
Feb 13, 2018·Current Treatment Options in Gastroenterology·Dennis Yang, Peter V Draganov
Aug 26, 2017·Indian Journal of Gastroenterology : Official Journal of the Indian Society of Gastroenterology·Santosh DarisettyD Nageshwar Reddy
Aug 28, 2019·Digestive Diseases and Sciences·Mitchell S CappellDavid Friedel
Mar 15, 2020·European Radiology·Maximilien BarretPhilippe Soyer
Jun 3, 2020·Endoscopy·Rachel HallitStanislas Chaussade
Feb 13, 2021·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Ashley A Norton-GregoryStephane L Desouches
Nov 12, 2020·Clinical and Experimental Gastroenterology·Pravallika ChadalavadaMadhusudhan R Sanaka
Jul 24, 2021·Clinical and Experimental Gastroenterology·Salih SamoQiang Cai
Aug 28, 2021·Endoscopy International Open·Saurabh ChandanDouglas G Adler
Sep 2, 2021·Endoscopy International Open·Marion ChartierMaximilien Barret