scholarly journals The Management of Endoscopic Retrograde Cholangiopancreatography-Related Duodenal Perforation

2014 ◽  
Vol 47 (4) ◽  
pp. 341 ◽  
Author(s):  
Kwang Bum Cho
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde

Risk Factors Of Pancreatitis After Endoscopic Retrograde Cholangiopancreatography – A Retrospective Cohort Study

2015 ◽  
Vol 87 (10) ◽  
Author(s):  
Stanisław Głuszek ◽  
Jarosław Matykiewicz ◽  
Dorota Kozieł ◽  
Dariusz Klimer ◽  
Iwona Wawrzycka ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Retrospective Cohort ◽  
Demographic Data ◽  
Young Patients ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde ◽  
Valuable Procedure ◽  
Biliary Ducts ◽  
The Common ◽  
Procedure Type

AbstractEndoscopic retrograde cholangiopancreatography (ERCP) is the most important non-surgical procedure in serious pancreatic and biliary diseases, still burdened with the risk of severe complications. The objective of the study was to distinguish factors which could increase the risk of occurrence of ERCP complication in the form of pancreatitis.The study included 452 patients who had undergone ERCP. Patients’ records were retrospectively analyzed from the aspect of demographic data, indications for the procedure, type and course of the procedure, type and severity of complications, width of the common bile duct (CBD), concomitant diseases and administered medicines which might increase the risk of complications.In 35 patients (7.7%) a complication occurred in the form of pancreatitis (AP). A severe course was confirmed in 11 patients (31%). Cholelithiasis constituted approximately 2/3 of indications for ERCP. AP after ERCP was significantly more often observed in the group of patients aged under 40 (22.9% vs 8.6%; p<0.05). Narrow biliary ducts (3-8 mm) were the factor increasing the frequency of development of AP (25.9% vs 45%; p<0.05). Death occurred in 5 patients (1.1%), including 4 patients (0.96%) in the group without complications, and in 1 patient (2.85%) with complicated AP.ERCP is a very valuable procedure in clinical treatment; however, it is burdened with the risk of complications, such as AP, bleeding, or duodenal perforation. A group especially exposed to the risk of complications in the form of AP are young patients aged under 40 with a narrow CBD.

Management of duodenal perforation after endoscopic retrograde cholangiopancreatography

1998 ◽  
Vol 114 ◽  
pp. A1428
Author(s):  
M.V. Stapfer ◽  
R. Yang ◽  
N. Jabour ◽  
S.C. Stain ◽  
R. Selby ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde

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 Pneumoperitoneum after Endoscopic Retrograde Cholangiopancreatography due to Rupture of Intrahepatic Bile Ducts and Glisson’s Capsule in Hepatic Metastasis: A Case Report and Review of Literature

2017 ◽  
Vol 11 (3) ◽  
pp. 603-609
Author(s):  
Zubair Khan ◽  
Umar Darr ◽  
Mohamad Nawras ◽  
Muhammad Bawany ◽  
Jacob Bieszczad ◽  
...  
Keyword(s):  
Case Report ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Hepatic Metastasis ◽  
Bile Ducts ◽  
Pancreatic Neuroendocrine Tumor ◽  
Duodenal Perforation ◽  
Metallic Stent ◽  
Endoscopic Retrograde ◽  
Intrahepatic Bile Ducts ◽  
Covered Metallic Stent

Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) has been proven to be a safe and effective method for diagnosis and treatment of biliary and pancreatic disorders. Major complications of ERCP include pancreatitis, hemorrhage, cholangitis, and duodenal perforation. We report a third case in literature of pneumoperitoneum after ERCP due to rupture of intrahepatic bile ducts and Glisson’s capsule in a peripheral hepatic lesion. Case Report: A 50-year-old male with a history of metastatic pancreatic neuroendocrine tumor and who had a partially covered metallic stent placed in the biliary tree 1 year ago presented to the oncology clinic with fatigue, abdominal pain, and hypotension. He was planned for ERCP for possible cholangitis secondary to obstructed previously placed biliary stent. However, the duodenoscope could not be advanced to the level of the major papilla because of narrowed pylorus and severely strictured duodenal sweep. Forward-view gastroscope was then passed with careful manipulation to the severely narrowed second part of the duodenum where the previously placed metallic stent was visualized. Balloon sweeping of stenting was done. Cholangiography did not show any leak. Following the procedure, the patient underwent CT scan of the abdomen that showed pneumoperitoneum which was communicating with pneumobilia through a loculated air collection in necrotic hepatic metastasis perforating Glisson’s capsule. The patient was managed conservatively. Conclusion: In our case, pneumoperitoneum resulted from rupture of intrahepatic bile ducts and Glisson’s capsule in hepatic metastasis. This case emphasizes the need for close clinical and radiological observation of patients with hepatic masses (primary or metastatic) subjected to ERCP.

scholarly journals Endoscopic closure of duodenal perforation post-endoscopic retrograde cholangiopancreatography: A case report

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Ramin Niknam ◽  
◽  
Gholam Reza Sivandzadeh ◽  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Common Bile Duct Stones ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde ◽  
Endoscopic Repair ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Endoscopic Closure ◽  
Endoscopic Clips

Background: Duodenal perforation post - Endoscopic Retrograde Cholangiopancreatography (ERCP) is uncommon, but if not treated well enough in time, it can have serious consequences. There are few reports that endoscopic-related duodenal perforation has been successfully treated using endoclips. Case presentation: A 63-year-old woman was referred for ERCP because of cholestatic jaundice caused by common bile duct stones. During the procedure, duodenal perforation post-ERCP was suggested. The endoscopic repair of the perforation was performed immediately using 5 endoscopic clips. Antibiotic therapy was also started and clinical and radiological follow-up was performed. Patient condition was good immediately after surgery and during hospitalization. Conclusion: Endoscopic treatment of duodenal perforation postERCP can be suggested as a treatment option in highly selected patients which may lead to a reduction in the frequency of surgical interventions. Keywords: endoscopic retrograde cholangiopancreatography; endoscopy; perforation; endoscopic clips.

scholarly journals Bilateral Pneumothorax and Subcutaneous Emphysema following Endoscopic Retrograde Cholangiopancreatography: A Rare Complication

2010 ◽  
Vol 2010 ◽  
pp. 1-3 ◽  
Author(s):  
Fotios Sampaziotis ◽  
Alan Wiles ◽  
Syed Shaukat ◽  
Richard J. Dickinson
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Subcutaneous Emphysema ◽  
Rare Complication ◽  
Pancreatic Disease ◽  
Therapeutic Modality ◽  
Duodenal Perforation ◽  
Chest Drain ◽  
Bilateral Pneumothorax ◽  
Endoscopic Retrograde ◽  
Quick Recovery

Endoscopic Retrograde Cholangiopancreatography (ERCP) is a widely used diagnostic and therapeutic modality in the management of biliary and pancreatic disease. Some of the complications of the procedure, although rare, may carry significant morbidity and mortality risks. We describe the case of a 68-year-old female who underwent elective ERCP for ductal stone clearance. Immediately postprocedure, the patient developed subcutaneous emphysema and bilateral pneumothoraces. Further imaging revealed the presence of free intra-abdominal air. The patient made a very quick recovery after bilateral chest drain insertion and no further intervention was required. We propose that pneumothorax, pneumomediastinum, and subcutaneous emphysema during ERCP, in the absence of duodenal perforation may be explained by leakage of air from a site of low resistance such as the sphincterotomy site, or as a result of copious Valsalva manoeuvres performed by a patient tolerating the procedure poorly.

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