Clin Endosc.  2012 Jun;45(2):177-180. 10.5946/ce.2012.45.2.177.

A Case of Ampullary Perforation Treated with a Temporally Covered Metal Stent

• Park WY
• Cho KB
• Kim ES
• Park KS

• KMID: 2048859
• DOI: http://doi.org/10.5946/ce.2012.45.2.177

Abstract

Endoscopic retrograde cholangiopancreatography (ERCP)-related perforation is classified into three or four types based on anatomical location and the mechanism of injury. Although ampullary injury, among them, may be managed nonsurgically, surgical management is required in cases of perforation with retroperitoneal fluid collection and severe condition. Here, a patient with ERCP-related severe ampullary perforation with retroperitoneal fluid collection that was treated nonsurgically with a covered stent is presented.

Keyword

Perforation; Endoscopic retrograde cholangiopancreatography; Stents

MeSH Terms

Cholangiopancreatography, Endoscopic Retrograde
Humans
Stents

Figure

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  Fig. 1 The Immediate post-endoscopic retrograde cholangiopancreatography images. (A) Duodenoscopic finding showing fully cut ampulla of vater after endoscopic sphicterotomy (EST). (B) Computed tomography showing collected air and fluid at right retroperitoneal space caused by EST.

• 

  Fig. 2 Images of the inserted stent. (A) Duodenoscopic finding showing the inserted covered-stent at ampulla of vater. (B) Abdominal computed tomography showing the metal stent in the common bile duct.

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  Fig. 3 The Follow-up images. (A) Balloon occluded cholangiogrphic finding showing no more leakage of the radiocontrast media at ampullary level. (B) Follow-up abdominal computed tomography showing complete resolution of the retroperitoneal air and fluid collection.

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