scholarly journals A Novel Cause of Biliary Peritonitis after Endoscopic Retrograde Cholangiopancreatography: Case Report and Literature Review

2021 ◽  
Vol 2021 ◽  
pp. 1-5
Author(s):  
Andrija Karačić ◽  
Paula Batur ◽  
Domagoj Štritof ◽  
Taro Fukui ◽  
Branko Bakula ◽  
...  
Keyword(s):  
Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Intrahepatic Bile Duct ◽  
Liver Parenchyma ◽  
Duodenal Perforation ◽  
Emergency Laparotomy ◽  
Endoscopic Retrograde ◽  
Biliary Peritonitis ◽  
First Case ◽  
Therapeutic Ercp

Background. Endoscopic retrograde cholangiopancreatography (ERCP) can lead to several complications such as duodenal or bile duct perforation. The incidence of pneumoperitoneum post-ERCP is rarely seen (<1%) and is associated with perforations of the duodenum or common bile duct in therapeutic ERCP after sphincterotomy. In this case, we disclose a novel cause of biliary peritonitis after ERCP. Case Presentation. A 65-year-old man presented with abdominal pain and distended abdomen after uneventful ERCP with sphincterotomy. An abdominal computed tomography (CT) was performed whose finding indicated duodenal perforation. The patient was rushed to an emergency laparotomy where only a rupture of an otherwise normal subcapsular intrahepatic bile duct was found. The surrounding liver parenchyma was healthy. The cause of this condition was probably post-ERCP pneumobilia and the increase of pressure in the biliary tract. Conclusions. This is the first case in literature describing the rupture of a subcapsular healthy bile duct as cause of biliary peritonitis after ERCP. This case also suggests that in the management of post-ERCP complications, the cooperation of radiologists and surgeons is vital for the patient’s wellbeing.

scholarly journals Endoscopic Retrograde Cholangiopancreatography Scope‑induced Duodenojejunal Flexure Perforation: The World’s First Case

2017 ◽  
Vol 08 (03) ◽  
pp. 145-147
Author(s):  
Jignesh A. Gandhi ◽  
Pravin H. Shinde ◽  
Basavaraj K. Nagur ◽  
Rohan D. Digarse
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Primary Closure ◽  
Early Recognition ◽  
Emergency Laparotomy ◽  
Significant Morbidity ◽  
Endoscopic Retrograde ◽  
The Third ◽  
First Case ◽  
Duodenojejunal Flexure ◽  
Life Threatening

ABSTRACTDuodenojejunal (DJ) flexure perforation is very rare. DJ flexure perforation following endoscopic retrograde cholangiopancreatography (ERCP) has not be documented till date. They are associated with significant morbidity and mortality. We present an ERCP‑induced DJ flexure perforation which has been treated with primary closure in two layers at our institution. To the best of our knowledge, this is the world’s first case. Such site of ERCP‑induced perforation has not been reported in literature till date. A 75‑year‑old female patient underwent repeated ERCP for obstructive jaundice. There was perforation during the third ERCP while removing the larger stone. Emergency laparotomy was performed with primary closure of perforation in two layers. ERCP‑induced DJ flexure perforation has not yet been documented. It is potentially life‑threatening. Early recognition may lead to a better prognosis through earlier intervention.

Laparoscopic-Assisted Transgastric Endoscopic Retrograde Cholangiopancreatography With Placement of a Biliary Stent to Treat Traumatic Intrahepatic Bile Duct Disruption in a Patient With Roux-en-Y Gastric Bypass

2021 ◽  
pp. 000313482110257
Author(s):  
Jaclyn N. Portelli Tremont ◽  
Ian M. Kratzke ◽  
Amirreza Motameni ◽  
Robert Nunoo ◽  
Ann Chung
Keyword(s):  
Gastric Bypass ◽  
Bile Duct ◽  
Blunt Trauma ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Intrahepatic Bile Duct ◽  
Interventional Treatment ◽  
Biliary Injury ◽  
Endoscopic Retrograde ◽  
Elevated Liver Enzymes ◽  
Laparoscopic Assisted

Hepatic injuries are common following blunt trauma and while frequently managed expectantly, biliary injury as a result of the trauma requires a high index of suspicion, a focused workup, and likely interventional treatment. A 44-year-old female with a history of Roux-en-Y gastric bypass presented after a ground level fall and was initially discharged home but represented with worsening abdominal pain and elevated liver enzymes. She was found to have a segment 5/6 biliary injury requiring laparoscopic-assisted transgastric endoscopic retrograde cholangiopancreatography with common bile duct stent placement. This case represents the difficulty of diagnosing biliary injuries following blunt trauma, and the need for advanced endoscopic interventions for treatment in patients with atypical anatomy.

scholarly journals Biliary Peritonitis Caused by Spontaneous Bile Duct Rupture in the Left Triangular Ligament of the Liver after Endoscopic Sphincterotomy for Choledocholithiasis

2021 ◽  
pp. 53-61
Author(s):  
Taro Fukui ◽  
Takeshi Chochi ◽  
Toru Maeda ◽  
Chunyong Lee ◽  
Yohnosuke Wada ◽  
...  
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Endoscopic Sphincterotomy ◽  
Fluid Collection ◽  
Rare Condition ◽  
Common Bile Duct Stones ◽  
Endoscopic Retrograde ◽  
Bile Duct Wall ◽  
Biliary Peritonitis

Spontaneous bile duct rupture is a rare condition in adults, with only 70 cases reported. Increased bile duct wall pressure may lead to rupture and biliary peritonitis. In this patient, the bile duct ruptured in the hepatic left triangular ligament. A 91-year-old man underwent endoscopic retrograde cholangiopancreatography for choledocholithiasis and endoscopic retrograde biliary drainage (ERBD) placement. One week later, removal of the ERBD and common bile duct stones and an endoscopic sphincterotomy (EST) were performed. Four days later, the patient had abdominal pain, increased inflammatory reaction, and jaundice. Abdominal computed tomography showed ascites, bile duct dilatation and fluid collection under the liver (10 cm in diameter). Emergency surgery was performed to drain the fluid. On laparotomy, encapsulated biliary ascites was seen. To search for the site of the leak, after cholecystectomy, a tube (C-tube) was inserted into the common bile duct via cystic duct stump. Because of uncontrollable bleeding, after packing with surgical gauze, the operation was temporarily stopped. The next day, reoperation was performed. Intraoperative cholangiography with contrast dye revealed the perforation site in the left triangular ligament and a partial resection was performed. Bile excretion from the C-tube was subsequently observed, but the patient’s jaundice did not improve. Although endoscopic retrograde cholangiopancreatography revealed that the EST site was normal, ERBD was placed again, and the jaundice gradually improved. Although EST was performed in this case, biliary peritonitis resulting from spontaneous bile duct rupture occurred. This case was very informative because biliary perforation may occur even after EST.

scholarly journals Duodenal Perforation Secondary to Migrated Biliary Stent: A Rare and Serious Complication of Endoscopic Retrograde Cholangiopancreatography

2018 ◽  
Vol 09 (04) ◽  
pp. 193-195
Author(s):  
Vipul D. Yagnik ◽  
Vismit P. Joshipura
Keyword(s):  
Abdominal Pain ◽  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Bile Duct Stone ◽  
Intestinal Wall ◽  
Biliary Stent ◽  
Duodenal Perforation ◽  
Biliary Stents ◽  
Endoscopic Retrograde

AbstractAlthough migration of biliary stents is not uncommon, stent‑induced perforation of the intestinal wall is a rare and serious complication. We report a case of duodenal perforation secondary to migrated biliary stent kept for obstructive jaundice for common bile duct stone in a 64‑year‑old male. Intestinal perforation secondary to migrated stent should be considered in patients reported with abdominal pain and sepsis after an endoscopic retrograde cholangiopancreatography with biliary stent placement.

scholarly journals Endoscopic Fistulotomy – ‘The Suprapapillary Punch’: A Method of Access to the Bile Duct during ERCP

1994 ◽  
Vol 8 (1) ◽  
pp. 33-35
Author(s):  
Noel B Hershfield
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Biliary Tree ◽  
Usual Method ◽  
Endoscopic Retrograde ◽  
The Common ◽  
A Minor ◽  
Endoscopic Fistulotomy

Endoscopic retrograde cholangiopancreatography (ERCP) is established as the method of choice to investigate the biliary tree when obstruction is suspected. On rare occasions, the papilla cannot be entered because of anatomical or pathological abnormalities. This report describes endoscopic fistulotomy or the suprapapillary punch that has been carried out at the Foothills Hospital in Calgary, Alberta, on 30 of 623 patients referred for ERCP for conditions causing obstruction of the common bile duct or suspected obstruction of the common bile duct. The following communication also describes the method of suprapapillary punch or endoscopic fistulotomy. Results have been excellent with only one complication, a minor attack of pancreatitis after the procedure. In summary, the suprapapillary punch or fistulotomy is a safe and useful method for entering the common bile duct when access by the usual method is impossible.

scholarly journals Management of choledocholithiasis after previous gastrectomy

2017 ◽  
Vol 99 (7) ◽  
pp. e213-e215
Author(s):  
S Anwer ◽  
R Egan ◽  
N Cross ◽  
S Guru Naidu ◽  
K Somasekar
Keyword(s):  
Bile Duct ◽  
Common Bile Duct ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Common Bile Duct Stones ◽  
Bile Duct Stones ◽  
Successful Management ◽  
Endoscopic Retrograde ◽  
Technical Challenge

Common bile duct stones in patients with a previous gastrectomy can be a technical challenge because of the altered anatomy. This paper presents the successful management of two such patients using non-traditional techniques as conventional endoscopic retrograde cholangiopancreatography was not possible.

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