Endoscopy 2002; 34(7): 585-587
DOI: 10.1055/s-2002-33208
Case Report
© Georg Thieme Verlag Stuttgart · New York

Uvular Necrosis after Upper Endoscopy: A Case Report and Review of the Literature

S.-J.  Tang1 , F.  Kanwal1 , I.  M.  Gralnek1
  • 1Division of Digestive Diseases, Dept. of Medicine, Center for the Health Sciences, University of California at Los Angeles School of Medicine, Los Angeles, California, USA
Further Information

Publication History

Submitted 2 August 2001

Accepted after Revision 25 February 2002

Publication Date:
12 August 2002 (online)

Uvular necrosis after endotracheal intubation or upper endoscopy is rare. We report here on a case of uvular necrosis and ulceration after endoscopy. The combination of ulceration and necrosis suggests uvular ischemia during endoscopy. The uvula may have been sandwiched between the shaft of the endoscope and the gum or hard palate, or may have been pressed against the posterior pharynx, leading to prolonged ischemia and resultant ulceration and necrosis. Uvular trauma can also be caused by oral pharyngeal suction. We recommend that post-endoscopy uvular necrosis should be managed conservatively based on the patient's symptoms. In all reported cases, and in the present case as well, the uvula healed and the symptoms resolved within 2 weeks (5 - 14 days) after the procedure. The uvula regained its normal appearance. Overall, these patients should have a good clinical outcome.

References

  • 1 Silvis S E, Nebel O, Rogers G. et al . Endoscopic complications: results of the 1974 American Society for Gastrointestinal Endoscopy Survey.  JAMA. 1976;  235 928-930
  • 2 Davis R E, Graham D Y. Endoscopic complications: the Texas experience.  Gastrointest Endosc. 1979;  25 146-149
  • 3 Zubarik R, Eisen G, Mastropietro C. et al . Prospective analysis of complications 30 days after outpatient upper endoscopy.  Am J Gastroenterol. 1999;  94 1539-1545
  • 4 Ravindran R, Priddy S. Uvular edema: a rare complication of endotracheal intubation (case report).  Anesthesiology. 1978;  48 374
  • 5 Kranz M A, Solomon D L, Poulos J G. Uvula necrosis following endotracheal intubation.  J Clin Anaesthesiol. 1994;  6 139-141
  • 6 Commins D J, Whittet H, Okoli U C, Ewart M. Postintubation uvular necrosis.  Anaesthesia. 1994;  49 457-458
  • 7 Harris M A, Kumar M. A rare complication of endotracheal intubation.  Lancet. 1997;  350 1820-1821
  • 8 Fich A, Ligumsky M, Wolnerman J S. Necrosis of the uvula after endoscopy [letter].  Gastrointest Endosc. 1984;  30 317
  • 9 Langdon D E. Complications after outpatient upper endoscopy [letter].  Am J Gastroenterol. 1999;  94 3379-3380
  • 10 Peghini P L, Salcedo J A, Al-Kawas F H. Traumatic uvulitis: a rare complication of upper GI endoscopy.  Gastrointest Endosc. 2001;  53 818-820

I. M. Gralnek, M.D., M.S.H.S.

Division of Digestive Diseases

44-138 CHS (MC 168417) · University of California, Los Angeles · 10833 Le Conte Avenue CHS · Los Angeles, CA 90095-1684 · USA

Fax: + 1-310-268-1510 ·

Email: igralnek@mednet.ucla.edu

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