Endoscopic Treatment of Duodenal Perforation
The standard treatment for gastrointestinal perforation secondary to an endoscopic procedure is surgical repair. Some authors advocate a conservative medical management. However, this approach may be associated with increased morbidity and mortality. We describe a case of duodenal perforation secondary to snare polypectomy that was successfully treated with endoclipping. Additional published case reports were reviewed. Current data suggest that endoclipping may be appropriate in the management of a select group of patients with iatrogenic gastrointestinal perforation.

Traditionally, gastrointestinal perforations secondary to endoscopic procedures have been managed surgically. Some authors advocate a nonsurgical approach in selective cases; however, this approach has a high failure rate and carries a significant risk of morbidity and mortality. Recently, few reports have described the use of an endoscopic clipping device to close traumatic or iatrogenic defects in the upper gastrointestinal tract. We describe a case of duodenal perforation after snare cautery excision of a polyp that was successfully treated by nonsurgical means using a clipping device.