Endoscopic Management of Procedure-Related Bleeding and Perforation

  • Alessandro RepiciEmail author
  • Angelo Zullo
  • Andrea Anderloni
  • Cesare Hassan


Bleeding and perforation are procedure-related adverse events for which endoscopic intervention in appropriate circumstances can result in a good clinical outcome. Several endoscopic devices, including through-the-scope and over-the-scope clips, endoscopic suturing, and covered stents, can be used alone or in combination to manage procedure-related bleeding and perforation. Prompt recognition of adverse events, excellent supportive care, device availability, and operator experience are among the key determinants for a successful endoscopic outcome. Minimally invasive endoscopic management offers the potential for faster recovery and at a lower cost compared to traditional surgical approaches.

This chapter includes supplementary videos.


Bleeding Clips Endoscopic mucosal resection Endoscopic submucosal dissection Endoscopic suturing Perforation Polypectomy Post-polypectomy bleeding Stents 

Supplementary material

Video 19.1

Application of dedicated hemostatic forceps for intra-procedural EMR-induced active bleeding (MP4 14246 kb)

Video 19.2

Over-the-scope clip placement for EMR-induced recurrent delayed bleeding (MP4 14114 kb)

Video 19.3

Over-the-scope clip closure of EMR-induced deep defect (MP4 28329 kb)

Video 19.4

Self-expandable metal stent placement for management of a dilation-induced esophageal perforation (MP4 38651 kb)

Video 19.5

Nonsurgical management of Boerhaave syndrome with endoscopic suturing and stent placement (MP4 64878 kb)


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Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  • Alessandro Repici
    • 1
    • 2
    Email author
  • Angelo Zullo
    • 1
  • Andrea Anderloni
    • 2
  • Cesare Hassan
    • 2
  1. 1.Digestive Endoscopy Unit, Department of GastroenterologyInstituto Clinico HumanitasMilanItaly
  2. 2.Gastroenterology and Digestive EndoscopyNuovo Regina Margherita HospitalRomeItaly

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