Duodenal perforation secondary to stent migration after ERCP for hepatobiliary tuberculosis: Case report of a lethal complication in a young patient
| Autor: | Hans Jesper F. Del Mundo, Juan Carlos Abon, Anthony R. Perez, Derek C. Resurreccion, Brent Andrew G. Viray |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
medicine.medical_specialty
Endoscopic retrograde cholangiopancreatography medicine.diagnostic_test business.industry medicine.medical_treatment Perforation (oil well) ERCP complications Stent Case Report Biliary Stenting medicine.disease Surgery Stent migration Biliary tract Acute abdomen medicine Pancreatitis Hepatobiliary tuberculosis medicine.symptom Mortality business Duodenal Perforation Biliary stenting |
| Zdroj: | International Journal of Surgery Case Reports |
| ISSN: | 2210-2612 |
| Popis: | Introduction Interventional internal drainage of the biliary tract has become an established procedure for the temporary and definitive treatment of biliary obstruction due to malignant or benign disease. The complication rate is reported to be so low that when feasible, this technique is preferred over a surgical drainage procedure. Presentation of a case A 26-year old woman was referred to the hepatopancreaticobiliary surgery service due to severe abdominal pain for 3 days after undergoing endoscopic retrograde cholangiopancreatography (ERCP). She underwent biliary dilatation and stent insertion for obstructive jaundice secondary to biliary stricture from hepatobiliary tuberculosis. The patient underwent exploratory laparotomy, peritoneal lavage, duodenorrhaphy and tube jejunostomy for bilious peritonitis and duodenal perforation from biliary stent migration. The patient died one day post-operation due to septic shock from secondary bacterial peritonitis. Discussion ERCP and other interventional endoscopic biliary interventions are increasingly being used for biliary obstruction. Despite the various complications which arise from these diagnostic and therapeutic modalities, complications are relatively uncommon. Duodenal perforation from biliary stent migration is a rare complication after undergoing ERCP and stenting. However, in patients presenting with severe pain and physical signs of acute abdomen after the procedure, it should always be a consideration. Conclusions Despite the relative safety of interventional techniques for biliary obstruction, complications like pancreatitis, hemorrhage and perforation may occur. Early recognition and high index of suspicion allows for early intervention with good outcomes. Duodenal perforation from stent migration can occur and when intervention is delayed may lead to morbidity and mortality. Highlights • ERCP and other endoscopic biliary interventions are increasingly being used for biliary obstruction. • Despite the safety of interventional techniques, complications like pancreatitis, hemorrhage and perforation may occur. • Duodenal perforation from stent migration can occur and when intervention is delayed may lead to morbidity and mortality. • Early recognition and high index of suspicion allows for early intervention with good outcomes. |
| Databáze: | OpenAIRE |
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