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Successful Nonsurgical Treatment of Pneumomediastinum, Pneumothorax, Pneumoperitoneum, Pneumoretroperitoneum, and Subcutaneous Emphysema following ERCP.

Fujii L, Lau A, Fleischer DE, Harrison ME - Gastroenterol Res Pract (2010)

Bottom Line: ERCP-related perforation is uncommon, but mortality rates are high.Diagnosis requires a high clinical suspicion for early detection to allow optimal management of the perforation and a better prognosis.Treatment depends on the location and mechanism and increasingly involves nonoperative management.

View Article: PubMed Central - PubMed

Affiliation: Mayo Clinic, 13400 E Shea Blvd, Department of Internal Medicine, Phoenix, AZ 85259, USA.

ABSTRACT
Complications related to endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis, hemorrhage, cholangitis, and perforation. ERCP-related perforation is uncommon, but mortality rates are high. Diagnosis requires a high clinical suspicion for early detection to allow optimal management of the perforation and a better prognosis. Treatment depends on the location and mechanism and increasingly involves nonoperative management. We report a case of successful nonsurgical treatment of a patient with extensive air involving the peritoneum, retroperitoneum, thorax, mediastinum, and subcutaneous tissues following an ERCP perforation.

No MeSH data available.


Related in: MedlinePlus

Transverse section of CT thorax showing subcutaneous emphysema, bilateral pneumothorax, and pneumomediastinum (arrow).
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fig4: Transverse section of CT thorax showing subcutaneous emphysema, bilateral pneumothorax, and pneumomediastinum (arrow).

Mentions: CT scan with intravenous and oral contrast of the thorax, abdomen and pelvis revealed diffuse subcutaneous emphysema (Figures 3–6), bilateral pneumothorax (Figures 3 and 4), pneumomediastinum (Figures 3 and 4), pneumoretroperitoneum (Figure 5), and pneumoperitoneum (Figures 5 and 6). The patient's solid organs were normal and there was no extravasation of oral contrast into the abdomen.


Successful Nonsurgical Treatment of Pneumomediastinum, Pneumothorax, Pneumoperitoneum, Pneumoretroperitoneum, and Subcutaneous Emphysema following ERCP.

Fujii L, Lau A, Fleischer DE, Harrison ME - Gastroenterol Res Pract (2010)

Transverse section of CT thorax showing subcutaneous emphysema, bilateral pneumothorax, and pneumomediastinum (arrow).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC2901617&req=5

fig4: Transverse section of CT thorax showing subcutaneous emphysema, bilateral pneumothorax, and pneumomediastinum (arrow).
Mentions: CT scan with intravenous and oral contrast of the thorax, abdomen and pelvis revealed diffuse subcutaneous emphysema (Figures 3–6), bilateral pneumothorax (Figures 3 and 4), pneumomediastinum (Figures 3 and 4), pneumoretroperitoneum (Figure 5), and pneumoperitoneum (Figures 5 and 6). The patient's solid organs were normal and there was no extravasation of oral contrast into the abdomen.

Bottom Line: ERCP-related perforation is uncommon, but mortality rates are high.Diagnosis requires a high clinical suspicion for early detection to allow optimal management of the perforation and a better prognosis.Treatment depends on the location and mechanism and increasingly involves nonoperative management.

View Article: PubMed Central - PubMed

Affiliation: Mayo Clinic, 13400 E Shea Blvd, Department of Internal Medicine, Phoenix, AZ 85259, USA.

ABSTRACT
Complications related to endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis, hemorrhage, cholangitis, and perforation. ERCP-related perforation is uncommon, but mortality rates are high. Diagnosis requires a high clinical suspicion for early detection to allow optimal management of the perforation and a better prognosis. Treatment depends on the location and mechanism and increasingly involves nonoperative management. We report a case of successful nonsurgical treatment of a patient with extensive air involving the peritoneum, retroperitoneum, thorax, mediastinum, and subcutaneous tissues following an ERCP perforation.

No MeSH data available.


Related in: MedlinePlus