Year 2023 / Volume 115 / Number 4
Letter
Endoscopic management of an iatrogenic duodenal perforation and choledocholithiasis in the same endoscopic retrograde cholangiopancreatography session

218-219

DOI: 10.17235/reed.2023.9339/2022

Carlos Castaño-Milla, Cristina Cuadrado-Tiemblo, Elena Resina Sierra, José Antonio Olmos-Jerez, Carlos Chavarría,

Abstract
We present the case of a 67-year-old female with recent cholecystectomy for symptomatic cholelithiasis. She was admitted to our hospital with right upper quadrant abdominal pain and vomiting. Laboratory analysis revealed hyperbilirubinemia with cytolysis and cholestasis. Abdominal ultrasound revealed a choledocholithiasis of 8 mm. Endoscopic retrograde cholangiopancreatography (ERCP) was scheduled. With the duodenoscope, after the reduction maneuver from the second duodenal portion to face the major papilla, a perforation of approximately 18 mm was identified in the contralateral wall distal to it. A gastroscope identified the perforation and a 9.5-11 x 6 mm over-the-scope-clip (OTSC) was placed after inserting its edges into the cap with aspiration (without approximation forceps).
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References
1. Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg. 2000;232(2):191-8.
2. González Valverde FM, Fernández López AJ. Management of duodenal perforations after endoscopic retrograde cholangiopancreatography. Rev Esp Enferm Dig. 2019;111(4):331-
3. Avgerinos DV, Llaguna OH, Lo AY, et al. Management of endoscopic retrograde cholangiopancreatography: related duodenal perforations. Surg Endosc. 2009;23(4):833-8.
4. Leal T, Gonçalves B, Ferreira A. Endoscopic resolution of a duodenal perforation due to a pancreatic stent. Rev Esp Enferm Dig. 2021;113(5):383.
5. Paspatis GA, Arvanitakis M, Dumonceau JM, et al. Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement - Update 2020. Endoscopy. 2020;52(9):792-810.
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Citation tools
Castaño-Milla C, Cuadrado-Tiemblo C, Resina Sierra E, Olmos-Jerez J, Chavarría C. Endoscopic management of an iatrogenic duodenal perforation and choledocholithiasis in the same endoscopic retrograde cholangiopancreatography session. 9339/2022


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Publication history

Received: 08/11/2022

Accepted: 31/12/2022

Online First: 16/01/2023

Published: 03/04/2023

Article revision time: 53 days

Article Online First time: 69 days

Article editing time: 146 days


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