Saratov JOURNAL of Medical and Scientific Research
Home

Variants of clinical manifestation of retroduodenal perforation at endoscopic papillosphincterotomy

Year: 2017, volume 13 Issue: №3 Pages: 544-548
Heading: Surgery Article type: Original article
Authors: Osumbekov R.B.
Organization:
Summary:

Objective: to study clinical manifestations of retroduodenal perforations in conducting ES and instrumental revision of the bile ducts, the study of predisposing factors, determining the optimal equipment trial cannulation. Material and Methods. On the experience of 41 observations was studied manifested symptoms, anatomical features, technology ES. Results. Retroduodenal perforation manifests progressive subcutaneous emphysema in the first 12 hours after EPST, acute dynamic ileus in the same period, pain with preserved peristalsis and more remote: hepatoduodenal ligament abscess, duodenal fistula of retroperitoneal space and pneumomediastinum. The use of conductors reduces the occurrence of perforation in 40%. Conclusion. It is revealed that retroduodenal perforation may occur in 6 clinical variants predisposing factors are atypical anatomical variants, trial cannulations without the use of conductors.

Keywords: dynamic observation after papillosphincterotomy , endoscopic papillosphincterotomy, retroperitoneal perforation

Bibliography:
1. Yurchenko VV. In the respect of difficult selective cannulation of the ampulla of Vater. Endoscopic surgery 2016; 3: 17-21
2. Cotton РВ, Joseph WL. ERCP: The Fundamentals. Wiley 2015; 432 p.
3. Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after ERCP and sphincterotomy. Annals of Surgery 2000; 232 (2): 191-198
4. Tarn F, Prindiville T, Wolfe B. Subcutaneous Emphysema as a Complication of Endoscopic Sphincterotomy of the Ampulla of Vater. Gastrointest Endosc 1989; 35 (5): 447-449
5. Alexiou K, Sakellaridis T, Sikalias N, et al. Subcutaneous Emphysema, Pneumomediastinum and Pneumoperitoneum after Unsuccessful ERCP: A Case Report. Cases Journal 2009; 2: 120
6. Peacock K, Van Winkle W. Surgery and biology of wound repair. Philadelphia: Saunders, 1970; 615 p.
7. Balalykin AS. Endoscopic abdominal surgery. Moscow: IMA-press, 1996; 152 p.
8. Ciaccia D, Branch MS, Baillie J. Pneumomediastinum after endoscopic sphincterotomy. Am J Gastroenterol 1995; 90 (3): 475-477
9. Markogiannakis H, Toutouzas KG, Pararas NV, et al. Bilateral pneumothorax following endoscopic retrograde cholangiopancreatography: a case report. Endoscopy 2007, 39 (Suppl 1): E195-10.1055/S-2007-966416

AttachmentSize
2017_03_544-548.pdf514.06 KB
All articles of the authors:

No votes yet