Unusual ERCP complication

Česká verzia

Authors: J. Valkovský ¹; J. Vrána ¹; J. Šmíd ¹; J. Kraus ¹; P. Kovala ¹; M. Kremer ¹; B. Šnajder ²; O. Kuchyňa ³
Authors place of work: Interní oddělení, Městská nemocnice Ostrava, p. o. ¹; Chirurgické oddělení, Městská nemocnice Ostrava, p. o. ²; Oddělení anesteziologie a resuscitace, Městská nemocnice Ostrava, p. o. ³
Published in the journal: Gastroent Hepatol 2014; 68(3): 209-211
Category: Digestive Endoscopy: Case Report

Summary

We present the case of a 68-year-old female patient sent by her GP for an ERCP because of a sonographic finding of biliary dilation with choledocholithiasis. Our patient underwent open cholecystectomy in 2002, the operation was complicated by a leakage of d. cysticus resolved by ERCP with an installation of a biliary stent. The patient did not comply with ambulatory dispensarisation, therefore the stent was left in the biliary tract for more than ten years. Extraction of the stent during ERCP immediately led to cardiorespiratory distress in the patient. A new biliary stent was introduced without delay. An urgent CT scan revealed a massive bilateral pneumothorax as a result of post-ERCP perforation.

Key words:
ERCP – complication – perforation – pneumomediastinum – pneumothorax

The authors declare they have no potential conflicts of interest concerning drugs, products, or services used in the study.

The Editorial Board declares that the manuscript met the ICMJE „uniform requirements“ for biomedical papers.

Submitted:
3. 2. 2014

Accepted:
18. 5. 2014

Zdroje

1. Stapfer M, Selby RR, Stain SC et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 2000; 232(2): 191–198.

2. Howard TJ, Tan T, Lehman GA et al. Classification and management of perforations complicating endoscopic sphincterotomy. Surgery 1999; 126(4): 658–663.

3. Enns R, Eloubeidi MA, Mergener K et al. ERCP-related perforations: risk factors and management. Endoscopy 2002; 34(4): 293–298.

4. Lee TH, Han JH, Park SH. Endoscopic treatments of endoscopic retrograde cholangiopancreatography-related duodenal perforations. Clin Endosc 2013; 46(5): 522–528.