Duodenal perforation post ERCP

Case contributed by Dr Henry Knipe

Presentation

Abdominal pain

Patient Data

Age: 60 years
Gender: Male

ERCP

Modality: Fluoroscopy

ERCP demonstrates extraluminal contrast and a pocket of subhepatic gas. Biliary tree is opacified, along with contrast within the gallbladder revealing numerous gallstones. 

Modality: X-ray

Free gas under both hemidiaphragms with patchy lucency in a subhepatic location, most likely pneumoretroperitoneum. 

Modality: CT

Large volume of retropneumoperitoneum and minor pneumoperitoneum. Free fluid which is within the retroperitoneum with very little intraperitoneal. No contrast leak from the duodenum identified. 

Cholelithiasis. Contrast within the gallbladder from the recent ERCP.

Case Discussion

Duodenal perforation post ERCP is rare, occurring in ~1% (range 0.3-1.3%) of cases. Some advocate a non-surgical approach to management in certain select patients. 

PlayAdd to Share

Case Information

rID: 46732
Case created: 14th Jul 2016
Last edited: 22nd Aug 2016
Inclusion in quiz mode: Included

Updating… Please wait.
Loadinganimation

Alert accept

Error Unable to process the form. Check for errors and try again.

Alert accept Thank you for updating your details.