MANAGEMENT OF DUODENAL PERFORATION AFTER ENDOSCOPIC RETROGRADE CHOLANGIOPANCREATOGRAPHY | ||
| The Egyptian Journal of Surgery | ||
| Volume 20, Issue 3, July 2001, Pages 691-695 PDF (408.35 K) | ||
| Document Type: Original Article | ||
| DOI: 10.21608/ejsur.2001.376365 | ||
| Authors | ||
| Essam Shelbaya* 1; Omar Eissa1; Ayman Hassenein1; Mohamed Rabie1; Sami M. Osmann2 | ||
| 1Departments of Surgery, EL-Minia University Hospitals, Egypt | ||
| 2Departments of Surgery, Sohag University Hospitals, Egypt | ||
| Abstract | ||
| Traditionally, duodenal perforations hove been managed surgically; however, recently, management has shifted to a more selective approach. The authors reviewed retrospectively, from January 1998 to June 2001, at the endoscopy units of El-Minia & Sohag University Hospitals, identified 12 instances of duodenal perforations related to EPCP, a rate of 2.5% of total procedures done. Charts were reviewed for the following: ERCP findings, mechanisms of injury, clinical presentation of perforation, diagnostic methods, time to diagnosis, methods of management, surgical procedures and outcome. Twelve patients had a duodenal perforation. Eight patients were initially managed conservatively. Two of the eight patients failed non-surgical management and a decision to operate was delayed to end fatally. Four patients were managed initially by surgery and one patient had a delayed surgical management due to missed diagnosis with fatal outcome on the 4th post - operative day. Clinical and radiographic features of ERCP-related duodenal injuries can be used to categorize patients into surgical or non-surgical groups. A selective management scheme is proposed. | ||
| Keywords | ||
| Duodenal perforation; ERCP; Endoscopic sphincterotomy | ||
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