Duodenal perforation and bilateral tension pneumothorax following endoscopic sphincterotomy

İyilikçi, Leyla; Akarsu, Mesut; Duran, Esra; Sarikaya, Huriye Begburs; Biyikli, Banu

doi:10.1007/s00540-008-0710-7

Cited by 2 publications

(3 citation statements)

References 8 publications

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“…Alternatively, some patients might have a congenital or surgically acquired communication between the two pleural spaces; this is known as "buffalo chest syndrome" [57]. In this condition, bilateral pneumothoraces could occur without a pneumomediastinum [20].…”

Section: Discussionmentioning

confidence: 99%

“…Surgical repair consisted of a direct suture alone [38], combined with an omental patch [31] or combined with a cholecystectomy and T-tube insertion [7,18,48]. In others, pyloric exclusion and gastrojejunostomy [4,29], tube duodenostomy [4,20,33], colostomy and mucous fistula [42] were performed. In another two cases the perforation could not be identified at laparotomy [17,23].…”

Section: Datamentioning

confidence: 99%

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Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography

Lehmann¹,

Keller

Egger

2020

Swiss Med Wkly

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AIMS OF THE STUDY: Pneumothoraces after endoscopic retrograde cholangiopancreatography (ERCP) are an uncommon but potentially lethal complication. Little evidence is available on their epidemiology, diagnosis and therapy. We aimed to evaluate current practices and provide recommendations.METHOD: We systematically reviewed articles from PubMed, Embase, OVID-Medline and the Cochrane Library.RESULTS: Forty-four publications reported pneumothoraces after ERCP in 49 patients (74% females). Twentyone patients (43%) had atypical gastrointestinal anatomy, including peri-ampullary diverticula (n = 8), surgical or endoscopic alterations (n = 7), local tumours (n = 3), ulcerations (n = 2) and ectopic papilla (n = 1). Precut (14%) or standard (39%) sphincterotomies were performed. Cannulation was unsuccessful in six ERCPs. Pneumothoraces occurred bilaterally (45%), on the right (37%) or left side (6%), or no side was stated (12%). Nineteen tension pneumothoraces occurred. Perforations were mainly caused by the sphincterotome, peri-ampullary (41%), or the endoscope, distant from the papilla of Vater (23%). Pneumothoraces were sometimes diagnosed only after hospital discharge (14%). Eighteen patients underwent surgical therapy with drainage, repair and/or bypass. Conservative treatment included antibiotics and bowel rest. Most pneumothoraces were drained; 14% resolved without pleural drainage. Overall mortality was 4%. The mean hospital stay was 9.8 days. CONCLUSIONS:A post-ERCP pneumothorax should be considered when subcutaneous emphysema, cardiovascular instability or respiratory distress occurs. Thoracoabdominal computed tomography facilitates identification and therapy tailoring. Because of possible late or discrete onset, patients should be monitored carefully.

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Section: Discussionmentioning

confidence: 99%

Section: Datamentioning

confidence: 99%

Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography

Lehmann¹,

Keller

Egger

2020

Swiss Med Wkly

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“…In many of the reported cases of pneumothorax after ERCP, even extensive radiographic imaging studies failed to show the site of perforation [6, 7, 12–14, 16–18, 21]. Laparotomy may fail to show perforation [13, 15] even when this was radiologically shown [7]. More important, however, is the clear absence of therapeutic implications of documenting actual intestinal leakage or the exact site of perforation.…”

Section: Discussionmentioning

confidence: 99%

Pneumothorax Following ERCP: Report of Four Cases and Review of the Literature

Schepers

Buuren

2012

Dig Dis Sci

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We report four patients with pneumothorax as a complication of ERCP with sphincterotomy. With conservative treatment all patients recovered. Previously, 16 comparable cases have been reported in the literature. The main risk factor for this rare complication seems (pre-cut) sphincterotomy. Pneumothorax is usually right-sided or bilateral and accompanied by pneumomediastinum, pneumoretroperitoneum and subcutaneous emphysema. The prognosis seems favourable with a non-surgical approach including intravenous antibiotics, fasting and when indicated chest tube drainage.

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Duodenal perforation and bilateral tension pneumothorax following endoscopic sphincterotomy

Cited by 2 publications

References 8 publications

Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography

Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography

Pneumothorax Following ERCP: Report of Four Cases and Review of the Literature

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