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Digestive Diseases and Sciences

, Volume 56, Issue 2, pp 610–611 | Cite as

Retroduodenal Perforation Without Sphincterotomy: A Case Report

  • John Menachery
  • Yogesh Chawla
  • Ajay Duseja
  • Radha K. Dhiman
  • Naveen Kalra
  • Sameer Vankar
Case Report

Introduction

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 [1]. 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

Case Presentation

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...

Keywords

Endoscopic retrograde cholangio pancreatography Perforation Guidewire Sphincterotomy 

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Copyright information

© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  • John Menachery
    • 1
  • Yogesh Chawla
    • 1
  • Ajay Duseja
    • 1
  • Radha K. Dhiman
    • 1
  • Naveen Kalra
    • 2
  • Sameer Vankar
    • 3
  1. 1.Department of HepatologyPost Graduate Institute of Medial Education and ResearchChandigarhIndia
  2. 2.Department of RadiodiagnosisPost Graduate Institute of Medial Education and ResearchChandigarhIndia
  3. 3.Department of Internal medicinePost Graduate Institute of Medial Education and ResearchChandigarhIndia

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