Endoscopic Retrograde Cholangiopancreatography-Related Large Jejunal Perforation: Operate or Apply Over-the-Scope Clip Device?
نویسندگان
چکیده
We have read with interest the review by Lee et al.1 titled “Endoscopic treatments of endoscopic retrograde cholangiopancreatography-related duodenal perforations.” Herein, we would like to describe the management of an analogous case from among our experience of 3,000 endoscopic retrograde cholangiopancreatographies (ERCPs) in 8 years. An 84-year-old man underwent ERCP because of recurrent cholangitis with intrahepatic bile duct dilatation, as seen on MRCP. The patient underwent a Billroth II gastrojejunostomy for the treatment of gastroduodenal ulcer disease 30 years earlier. During ERCP, multiple attempts to introduce the scope were made because of difficulty in approaching the papilla. An endoscope-related perforation was visualized at the end of the afferent loop (Fig. 1). The diameter of the defect Clin Endosc 2014;47:281-283
منابع مشابه
Endoscopic closure of duodenal perforation with an over-the-scope clip during endoscopic ultrasound-guided cholangiopancreatography.
A 74-year-old woman presented obstructive jaundice. Computed tomography revealed a pancreatic head tumor with dilatation of the common bile duct (CBD) and pulmonary metastases. Biliary drainage by ERCP was indicated. Papilla had tumoral signs of infiltration. Cannulation was not achieved after several attempts with a papillotome. We accessed the distal CBD after performing a pre-cut, but the gu...
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Uneventful duodenal perforation during endoscopic retrograde cholangiopancreatography (ERCP) is an uncommon but occasionally fatal complication. ERCP-related perforations may occur during sphincterotomy and improper manipulation of the equipment and scope. Traditionally, duodenal perforation has been treated with early surgical repair. Recently, nonoperative early endoscopic management techniqu...
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The management strategy for endoscopic retrograde cholangiopancreatography-related duodenal perforation can be determined based on the site and extent of injury, the patient's condition, and time to diagnosis. Most cases of perivaterian or bile duct perforation can be managed with a biliary stent or nasobiliary drainage. Duodenal wall perforations had been treated with immediate surgical repair...
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