Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

Abstract Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.

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Role of Endoscopic Retrograde Cholangiopancreatography in the Diagnosis of Choledocholithiasis

Pielegniarstwo XXI wieku / Nursing in the 21st Century ◽

10.1515/pielxxiw-2016-0037 ◽

2016 ◽

Vol 15 (4) ◽

pp. 48-52

Author(s):

Jolanta Borgosz ◽

Bogusława Kupczak-Wiśniowska ◽

Beata Podsiadło ◽

Bogusława Serzysko

Keyword(s):

Literature Review ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Potential Risk ◽

Bile Ducts ◽

Diagnostic Method ◽

Clinical Symptoms ◽

Reference Method ◽

Endoscopic Retrograde ◽

Life Threatening

Abstract Introduction. Retrograde cholangiopancreatography (ERCP) is a validated reference method for detection and treatment of choledocholithiasis. It can be performed at any stage of treatment. It allows for differentiation of bile retention causes, assessment of the level of bile ducts dilation, location of the obstruction level and establishment of recommendations for invasive bile ducts tests. Despite varied course of choledocholithiasis, swift detection and removal of stones from bile ducts should be striven for due to a potential risk of life-threatening complications.Aim. The aim of the study was to evaluate the diagnostic effectiveness of the retrograde cholangiopancreatography in patients with suspected bile ducts choledocholithiasis.Material and methods. Based on the literature review, the retrograde cholangiopancreatography in the diagnostics of bile ducts choledocholithiasis has been evaluated. Identification of choledocholithiasis, regardless of clinical symptoms, is associated with the decision to remove deposits from bile ducts. ERCP is the method of choice.Conclusions. As studies by numerous authors show, cholelithiasis can be the leading cause of cholangitis and pancreatitis. Diagnostic ERCP with evacuation deposits remains the most recommended diagnostic method in such cases.

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S2501 Delayed Post Sphincterotomy Bleed and Clot-Induced Cholangitis: A Rare but Life-Threatening Complication of Endoscopic Retrograde Cholangiopancreatography

The American Journal of Gastroenterology ◽

10.14309/01.ajg.0000783536.51444.43 ◽

2021 ◽

Vol 116 (1) ◽

pp. S1056-S1056

Author(s):

Ram Gopal Teja ◽

Ayaskanta Singh ◽

Jimmy Narayan ◽

Manas Behera ◽

Manoj Sahu ◽

...

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Endoscopic Retrograde ◽

Life Threatening ◽

Life Threatening Complication

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An Unexpected Complication of Endoscopic Retrograde Cholangiopancreatography with a Novel Treatment Approach

Case Reports in Gastroenterology ◽

10.1159/000509737 ◽

2020 ◽

Vol 14 (3) ◽

pp. 604-608

Author(s):

Jeremy Polman ◽

Aaron C. Williams ◽

Gaetano Ruggiero ◽

Aaron DeWitt

Keyword(s):

Endoscopic Retrograde Cholangiopancreatography ◽

Splenic Injury ◽

Treatment Approach ◽

Rare Complication ◽

Artery Embolization ◽

Endoscopic Retrograde ◽

Splenic Artery Embolization ◽

Major Hemorrhage ◽

Novel Treatment ◽

High Index Of Suspicion

Splenic injury after endoscopic retrograde cholangiopancreatography (ERCP) has been documented in less than 30 cases. Here, we present a case that involves a 52-year-old male with choledocholithiasis who developed a splenic injury and major hemorrhage immediately after ERCP. The patient ultimately required splenic artery embolization without splenectomy, a novel treatment approach. The case demonstrates the importance of having a high index of suspicion of this rare complication as well as discusses potential causes of post-ERCP splenic injury and a treatment approach that does not involve splenectomy.

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ERCP-Related Duodenal Perforation Presenting as Pneumoscrotum

Case Reports in Gastroenterology ◽

10.1159/000485557 ◽

2018 ◽

Vol 12 (1) ◽

pp. 1-6

Author(s):

Mohammad Saud Khan ◽

Faisal Jamal ◽

Zubair Khan ◽

Abhinav Tiwari ◽

Hermann Simo ◽

...

Keyword(s):

Supportive Care ◽

Male Patient ◽

Subcutaneous Emphysema ◽

Duodenal Perforation ◽

Close Monitoring ◽

Air Leak ◽

Endoscopic Retrograde ◽

Scrotal Pain ◽

Life Threatening ◽

Life Threatening Complication

Duodenal perforation is a rare but life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP). Duodenal perforation can cause air leak into the extraperitoneal space. In rare instances, the air in the extraperitoneal space could dissect along the fascial planes of the abdomen to reach scrotum, leading to pneumoscrotum. We present the case of a 35-year-old male patient who developed scrotal pain and swelling following ERCP. He was found to have extensive pneumoscrotum, pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema. The patient was diagnosed with retroperitoneal duodenal perforation. He was managed conservatively with close monitoring and supportive care.

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Heterotopic pregnancy; case report

National Journal of Research in Ayurved Science ◽

10.52482/ayurlog.v7i05.425 ◽

2019 ◽

Vol 7 (05) ◽

Author(s):

Vipul R. Khandagale

Keyword(s):

Risk Factors ◽

Ectopic Pregnancy ◽

Adnexal Mass ◽

Heterotopic Pregnancy ◽

Free Fluid ◽

Threatening Condition ◽

Life Threatening ◽

Ectopic Pregnancies ◽

High Index Of Suspicion ◽

Low Risk Women

Heterotopic pregnancy is a rare clinical condition in which intrauterine and extrauterine pregnancies occur at the same time. It can be a life threatening condition and easily missed with the diagnosis. We present the case of a 37 year old patient who was treated for a heterotopic pregnancy with live intrauterine gestation and ruptured left adnexal gestation.The ectopic pregnancy was not suspected at her initial presentation. A high index of suspicion is needed in women with risk factors for an ectopic pregnancy and in low risk women who have free fluid with or without an adnexal mass with an intrauterine gestation.It is difficult to estimate exactly the incidence of ectopic pregnancies, but on an average it is approximately 1:300 normal pregnancies worldwide.

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Risk factors for adverse events associated with endoscopic retrograde cholangiopancreatography in patients with surgically altered anatomy: a retrospective study

BMC Gastroenterology ◽

10.1186/s12876-021-02031-w ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Xiaojia Chen ◽

Fan Wang ◽

Jing Liu ◽

Wenhui Tao ◽

Zhang Zhang ◽

...

Keyword(s):

Risk Factors ◽

Bile Duct ◽

Adverse Events ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Univariate Analysis ◽

Balloon Dilation ◽

Endoscopic Papillary Balloon Dilation ◽

Endoscopic Retrograde ◽

Therapeutic Success ◽

Surgically Altered Anatomy

Abstract Introduction Endoscopic retrograde cholangiopancreatography (ERCP) is considered to be a challenge in patients with surgically altered anatomy. We aimed to identify the risk factors of ERCP-related adverse events in patients with surgically altered anatomy in our center. Methods We included patients with surgically altered anatomy who underwent ERCP between April 2017 and December 2020 at our center. Clinical characteristics and outcomes were analyzed in univariate and multivariate methods to identify the risk factors for adverse events. Results A total of 121 ERCP procedures were performed in 93 patients. The papilla or surgical anastomosis was successfully reached in 113 cases (93.4%). Diagnostic success was achieved in 106 cases (93.8%) and subsequent therapeutic success was achieved in 102 cases (96.2%). ERCP-related adverse events occurred in 31 cases (25.6%). In univariate analysis, not first time ERCP attempt, a CBD stone diameter ≥ 15 mm, multiple cannulation attempts, endoscopic papillary balloon dilation, endoscopic papillary large balloon dilation, endoscopic retrograde biliary drainage, biopsy in the bile duct or papilla, mechanical lithotripsy use, and stone retrieval basket were associated with ERCP-related adverse events. In multivariate analysis, multiple cannulation attempts (OR 5.283; 95% CI 1.088–25.659; p = 0.039), endoscopic papillary balloon dilation (OR 4.381; 95% CI 1.191–16.114; p = 0.026), and biopsy in the bile duct or papilla (OR 35.432; 95% CI 2.693–466.104; p = 0.007) were independently associated with ERCP-related adverse events. Conclusions ERCP in patients with surgically altered anatomy was feasible and safe. Interventions including multiple cannulation attempts, endoscopic papillary balloon dilation, and biopsy in the bile duct or papilla were independent risk factors for ERCP-related adverse events.

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Risk factors for perforation during endoscopic retrograde cholangiopancreatography in post-reconstruction intestinal tract

World Journal of Clinical Cases ◽

10.12998/wjcc.v7.i1.10 ◽

2019 ◽

Vol 7 (1) ◽

pp. 10-18 ◽

Cited By ~ 3

Author(s):

Shinichi Takano ◽

Mitsuharu Fukasawa ◽

Hiroko Shindo ◽

Ei Takahashi ◽

Sumio Hirose ◽

...

Keyword(s):

Risk Factors ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Intestinal Tract ◽

Endoscopic Retrograde

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Hepatic Hydatid cyst Cystobiliary Communication, Case Report & Literature Review

10.47363/jghr/2020(1)103 ◽

2020 ◽

Vol 1 (1) ◽

pp. 1-3

Author(s):

Hallal Mahmoud ◽

◽

Mroue Ahmad ◽

Kayal Mira ◽

◽

...

Keyword(s):

Case Report ◽

Literature Review ◽

Obstructive Jaundice ◽

Hydatid Cyst ◽

Endoscopic Retrograde Cholangiopancreatography ◽

Hydatid Cysts ◽

Hepatic Hydatid Cyst ◽

Endoscopic Retrograde ◽

Surgical Treatments ◽

Hepatic Hydatid

Hepatic hydatid cysts are benign cysts in the liver that are the result of parasites infection. They are caused by echinoccocus granulosis or multilocularis. They caused several symptoms like pain, obstructive jaundice, and sepsis. Hydatid cyst can be complicated to cystobiliary communication (CBC) which can be frank CBC or occult CBC. Medical, endoscopic, percutaneous and surgical treatments are different approaches to treat hydatid cyst. Here we report a case of hepatic hydatid cyst with cystobiliary communication, causing obstructive jaundice and treated with sphincterotomy and insertion of biliary stent through endoscopic retrograde cholangiopancreatography (ERCP).

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