NONAKA Kouichi    Department   School of Medicine(Tokyo Women's Medical University Hospital), School of Medicine    Position   Professor
Article types	Case report
Language	English
Peer review	Non peer reviewed
Title	Emergency lower gastrointestinal endoscopy performed safely in a COVID-19 patient on extracorporeal membrane oxygenation (ECMO) with hemorrhagic shock.
Journal	Formal name：Clinical journal of gastroenterology Abbreviation：Clin J Gastroenterol ISSN code：18657265/18657265
Domestic / Foregin	Foregin
Volume, Issue, Page	14(4),pp.1182-1185
Author and coauthor	MISUMI Yoshitsugu, FUJII Yuko, YAGUCHI Arino, NONAKA Kouichi
Authorship	Last author
Publication date	2021/08
Summary	Emergency endoscopy in coronavirus disease 2019 (COVID-19) patients should be avoided whenever possible to ensure the safety of medical staff; however, it may be unavoidable in some cases. We report a case of emergency lower gastrointestinal endoscopy performed with full personal protective equipment in a patient on extracorporeal membrane oxygenation with severe COVID-19 pneumonia admitted in a restricted area under negative pressure in the intensive care unit. To avoid the risk of fecal-oral transmission of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) during the procedure, the patient's lower body was covered with a 2 m2 vinyl sheet with an aperture (diameter, approximately 2 cm). None of the medical staff involved exhibited any signs of SARS-CoV-2 infection after the procedure. Although patients with severe COVID-19 pneumonia on extracorporeal membrane oxygenation have a high risk of bleeding, we believe that emergency lower endoscopy can be safely performed in such patients by reducing exposure to dispersed feces and using full personal protective equipment.
DOI	10.1007/s12328-021-01439-x
PMID	34008112