Retroduodenal Perforation Without Sphincterotomy: A Case Report
Endoscopic retrograde cholangiopancreatography (ERCP) is being increasingly used in the diagnosis and management of patients with pancreaticobiliary diseases, as it carries a lower morbidity and mortality rate than surgery . ERCP can occasionally be associated with complications including retroduodenal perforation (0.5–1%), especially following endoscopic sphincterotomy (ES) [2, 3]. Uncommonly, perforations can occur in patients with friable mucosa even without ES [4, 5, 6]. We describe a patient with peri-ampullary carcinoma in whom a retroduodenal perforation occurred without ES possibly due to guidewire manipulation of the friable tumour
A 55-year-old man was admitted with abdominal pain for 3 months and extrahepatic biliary obstruction for 1 month. He also had low grade fever over the preceding week. Examination revealed hepatomegaly and a palpable gall bladder. His hemogram showed leucocytosis. His total bilirubin was 16 mg/dl, with a direct...
KeywordsEndoscopic retrograde cholangio pancreatography Perforation Guidewire Sphincterotomy