Fatal complications of endoscopic ultrasonography: a look at 18 cases

Endoscopic ultrasonography (EUS) is perceived and reported to be a very safe procedure, at least in expert hands. Biennial assessment of all EUS procedures done in Israel since 1999 shows 8 cases of fatal EUS complications out of a total of 20 000 procedures. In seven of the eight cases tears of the duodenum were involved (all occurring with linear-type echoendoscopes); none involved fine-needle aspiration biopsy (FNA). Duodenal diverticuli were noted in four of the eight cases. Limited experience with linear echoendoscopes on the part of the operator (around 100 procedures or fewer) was common (five of the eight cases).

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