Dural tear with severe irrigation-related complications during unilateral biportal endoscopy under general anesthesia: a case series and literature review

Key Takeaways for GI Nurses

• This case series highlights critical complications from unilateral biportal endoscopy that may present in patients transferred to GI units for post-procedural care or emergency evaluation
• Understanding irrigation-related complications helps nurses recognize potential neurological symptoms that could manifest in patients with recent spine procedures who present for GI evaluation
• Dural tear complications can create complex clinical presentations that may mimic or complicate gastrointestinal symptoms, requiring heightened assessment skills
• Knowledge of these severe complications reinforces the importance of thorough pre-procedural assessment when patients have recent surgical histories involving endoscopic techniques

Clinical Relevance

While this research focuses on spinal endoscopy rather than gastrointestinal procedures, the findings have significant implications for GI nursing practice. Patients who experience complications from spinal endoscopic procedures may present to emergency departments or be transferred to medical units where GI nurses provide care. Understanding these potential complications helps nurses conduct more comprehensive assessments, particularly when patients present with complex symptom patterns that could involve both neurological and gastrointestinal components.

The emphasis on irrigation-related complications serves as an important reminder for GI nurses about the critical nature of fluid management during any endoscopic procedure. This case series reinforces existing protocols around monitoring fluid balance, recognizing signs of fluid overload or electrolyte imbalances, and understanding how irrigation complications can create cascading effects throughout multiple body systems. For endoscopy nurses, this research underscores the importance of meticulous attention to irrigation pressure, fluid temperature, and volume monitoring during all procedures involving continuous irrigation.

From a professional development perspective, this publication demonstrates the interconnected nature of various endoscopic specialties and the value of staying informed about complications across different procedural areas. GI nurses who understand complications from other endoscopic procedures are better equipped to provide comprehensive patient care, especially in settings where patients may have multiple comorbidities or recent procedural histories that could influence their current clinical presentation.

Bottom Line

This case series, while focused on spinal endoscopy, provides valuable insights for GI nurses about severe complications related to endoscopic irrigation and dural injuries that could impact patients presenting for gastrointestinal care. The research reinforces the critical importance of comprehensive patient assessment, thorough procedural history-taking, and understanding how complications from various endoscopic procedures can create complex clinical presentations that may involve multiple body systems requiring coordinated nursing care.