Retroperitoneal Perforation of the Duodenum

Radiology ◽  
1947 ◽  
Vol 48 (2) ◽  
pp. 164-167 ◽  
Author(s):  
E. C. Koenig ◽  
Gordon J. Culver
Keyword(s):  
Retroperitoneal Perforation

scholarly journals Are complications of endoscopic sphincterotomy age related?

Gut ◽  
1997 ◽  
Vol 41 (4) ◽  
pp. 545-548 ◽  
Author(s):  
G T Deans ◽  
P Sedman ◽  
D F Martin ◽  
C M S Royston ◽  
C K Leow ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Endoscopic Sphincterotomy ◽  
Short Term ◽  
Endoscopic Retrograde ◽  
Younger Patients ◽  
Age Related ◽  
Increased Risk ◽  
Ascending Cholangitis ◽  
Retroperitoneal Perforation ◽  
The Common

Background—Endoscopic retrograde cholangiopancreatography sphincterotomy is increasingly performed in younger patients undergoing laparoscopic cholecystectomy. However, the safety of endo- scopic sphincterotomy in this age group, relative to that in older patients, is unknown.Aim—To determine whether the development of short term complications following endoscopic sphincterotomy is age related.Patients and methods—A prospective multicentre audit of 958 patients (mean age 73, range 14–97, years) undergoing a total of 1000 endoscopic sphincterotomies.Results—Two deaths occurred, both from postsphincterotomy acute pancreatitis. Postprocedural complications developed in 24 patients: pancreatitis in 10, ascending cholangitis in seven, bleeding in four, and retroperitoneal perforation in three. There were six complications (five cases of pancreatitis and one bleed; 2.2%) and no deaths in the 281 (29.3%) patients aged under 65 years. In comparison, 18 (2.6%) of the 677 patients aged over 65 years developed a complication (cholangitis in seven, pancreatitis in five, bleeding in three, and perforation in three). Patients under 35, 45, 55, and 65 years were not at significantly increased risk of complication than those over these ages (relative risk for those under compared with those over 65 years 0.83, 95% confidence intervals 0.41–1.67, p=0.74).Conclusion—Short term complications following endoscopic sphincterotomy are not related to age. Younger patients undergoing laparoscopic cholecystectomy need not be denied endoscopic sphincterotomy for fear that the risks are greater than if they undergo surgical exploration of the common bile duct.

scholarly journals Pneumoretroperitoneum and Pneumomediastinum Revealing a Left Colon Perforation

2015 ◽  
Vol 100 (6) ◽  
pp. 984-988 ◽  
Author(s):  
Giulia Montori ◽  
Giacomo Di Giovanni ◽  
Zeineb Mzoughi ◽  
Cedric Angot ◽  
Sophie Al Samman ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Clinical Laboratory ◽  
Left Thigh ◽  
Left Colon ◽  
Colon Perforation ◽  
Emergency Laparotomy ◽  
Computed Tomography Scan ◽  
End Colostomy ◽  
Retroperitoneal Perforation ◽  
Tomography Scan

Left colon perforation usually occurs in complicated diverticulitis or cancer. The most frequent signs are intraperitoneal abscess or peritonitis. In cases of retroperitoneal colonic perforation, diagnosis may be difficult. A 59-year-old woman presented with left thigh pain and with abdominal discomfort associated with mild dyspnea. Computed tomography scan showed air bubbles and purulent collection in the retroperitoneum, with subcutaneous emphysema extending from the left thigh to the neck. Computed tomography scan also revealed portal vein gas and thrombosis with multiple liver abscesses. An emergency laparotomy revealed a perforation of the proximal left colon. No masses were found. A left colectomy was performed. The retroperitoneum was drained and washed extensively. A negative pressure wound therapy was applied. A second-look laparotomy was performed 48 hours later. The retroperitoneum was drained and an end colostomy was performed. Intensive Care Unit postoperative stay was 9 days, and the patient was discharged on the 32nd postoperative day. Pneumoretroperitoneum and pneumomediastinum are rare signs of colonic retroperitoneal perforation. The diagnosis may be delayed, especially in the absence of peritoneal irritation. Clinical, laboratory, and especially radiologic parameters might be useful. Surgical treatment must be prompt to improve prognosis.

scholarly journals Necrotising fasciitis of the left leg caused by perforated caecal adenocarcinoma

2017 ◽  
Vol 99 (8) ◽  
pp. e223-e224 ◽  
Author(s):  
S Pouriki ◽  
M Skalistira ◽  
C Zoumpouli ◽  
N Alexakis
Keyword(s):  
Computed Tomography ◽  
Abdominal Pain ◽  
Organ Failure ◽  
Right Hemicolectomy ◽  
Left Thigh ◽  
Necrotising Fasciitis ◽  
Necrotic Tissue ◽  
Retroperitoneal Perforation ◽  
Skin Discoloration ◽  
Caecal Perforation

An 82-year-old man presented with abdominal pain and a painful and swollen left thigh. On examination there was oedema, tenderness and crepitus with skin discoloration of the left thigh. Computed tomography showed retroperitoneal perforation of the caecum and necrotising fasciitis of the left thigh. A right hemicolectomy and repeated fasciotomies of the left thigh with debridement of necrotic tissue were performed but the patient died of multi-organ failure. Histology showed a pT4aN2c caecal adenocarcinoma. This is a unique presentation of a retroperitoneal caecal perforation and acts as a reminder that unexplained severe fasciitis of the thigh may be caused by an intra-abdominal pathology.

The “veiled right kidney sign”—an ultrasound finding in retroperitoneal perforation of the duodenum

1996 ◽  
Vol 69 (827) ◽  
pp. 1061-1063 ◽  
Author(s):  
R G McWilliams ◽  
A Blakeborough ◽  
M I Johnson ◽  
M Weston
Keyword(s):  
Ultrasound Finding ◽  
Retroperitoneal Perforation

scholarly journals Retroperitoneal perforation of a duodenal diverticulum containing a large enterolith after Roux-en-Y bypass and cholecystectomy

2020 ◽  
Vol 2020 (2) ◽  
Author(s):  
Nina Kabelitz ◽  
Berit Brinken ◽  
Rudolf Bumm
Keyword(s):  
Gastric Bypass ◽  
Rare Complication ◽  
Duodenal Diverticulum ◽  
Gallbladder Motility ◽  
Food Passage ◽  
Life Threatening ◽  
Retroperitoneal Perforation ◽  
Biliary Stasis ◽  
Threatening Situation ◽  
Upper Abdomen

Abstract Roux-en-Y gastric bypass (RYGB) is one of the most frequently performed bariatric procedures worldwide. The postoperative incidence of cholelithiasis after RYGB is higher than in the general population (30% vs. 2–5%), because the altered anatomy may lead to impaired gallbladder motility and biliary stasis. We report the case of a 47-year-old female who presented 9 years after RYGB and cholecystectomy with acute pain in the upper abdomen because of a retroperitoneal perforation of a duodenal diverticulum. Intraoperatively, a huge enterolith was found in the diverticulum and removed via duodenotomy. We claim that the stone grew during the sober states as the bile accumulated locally, because the gall bladder has already been removed and no duodenal food passage remained. This acute and life-threatening situation was successfully managed by operation. Consequently, a duodenal diverticulum has to be considered as a possible but very rare complication after RYGB and cholecystectomy.

scholarly journals Endoscopic Extraction of CBD Stone: single centre experience in tertiary care centre

2020 ◽  
Vol 9 (1) ◽  
pp. 29-33
Author(s):  
Arun Gnawali ◽  
Rahul Pathak ◽  
Rajesh Pandey ◽  
Prem Krishna Khadga ◽  
Sashi Sharma ◽  
...  
Keyword(s):  
Tertiary Care ◽  
Balloon Catheter ◽  
Tertiary Care Centre ◽  
Initial Attempt ◽  
Cbd Stones ◽  
Single Centre Experience ◽  
Endoscopic Extraction ◽  
Retroperitoneal Perforation ◽  
Cbd Stone ◽  
A Prospective Study

Background and Aims: Introduction: Endoscopic Retrograde Cholangiopancreatography(ERCP) has become the first line treatment for patients with common bile duct (CBD) stones. This technique may fail, however, due to presence of a large stone, multiple stones, periampullary diverticula or CBD stricture. The aim of this study was to evaluate the success of CBD cannulation, Endoscopic Sphincterotomy(EST) and CBD clearance in initial attempt, identify the failures of stone extraction and assess the post-ERCP complications. Methods: A prospective study was carried out over the period of January 2019 to January 2020 on 100 consecutive patients with CBD stones. ERCP was done and the stone size and number recorded. EST was performed using a diathermy unit with a cutting current and stones were extracted using a Balloon catheter or a Dormia basket. Results: Of the 100 patients, 44 were male and 56 were female with mean age of 52}17years. Selective CBD cannulation and cholangiogram was achieved in 90%, EST was successful in 90% and complete stone clearance was achieved in first attempt in 46 patients (59%). 52 patients had difficult CBD stone. There were nine complications, most of which rapidly resolved on conservative treatment (four post-ERCP pancreatitis, three bleeding and one retroperitoneal perforation) and one mortality in an old lady due to PSVT that couldn’t be directly attributed to ERCP. Among patients with Stone less than 15 mm in diameter(n=58), stone was removed successfully in 45 patients(78%) whereas in patients with stones over 15 mm (n=20) only one was removed successfully (5%) at initial attempt. Of these 32 patients with residual stones, 13 were referred for surgery and 19 had insertion of biliary stent to be followed by repeat ERCP. Conclusion: Endoscopic therapy is a simple, effective and safe method of treatment in patients with CBD stone.  

Management of infected caval filter with simultaneous aortic pseudoaneurysm and retroperitoneal perforation: a case report and literature review

Vascular ◽  
2012 ◽  
Vol 20 (4) ◽  
pp. 225-228 ◽  
Author(s):  
M Mura Assifi ◽  
Gabor Bagameri ◽  
Paul J Dimuzio ◽  
Joshua A Eisenberg
Keyword(s):  
Inferior Vena ◽  
Intravenous Drug User ◽  
Vena Cava ◽  
Operative Management ◽  
Iliopsoas Muscle ◽  
Complication Rates ◽  
Aortic Pseudoaneurysm ◽  
Ivc Filters ◽  
Multiple Structures ◽  
Retroperitoneal Perforation

Inferior vena cava (IVC) filters have been reported to have complication rates up to 35%. Penetration of surrounding retroperitoneal structures is an uncommon, but potentially serious, complication, with several reports in the literature. We present a unique case of a 34-year-old intravenous drug user with infected IVC filter struts penetrating multiple structures simultaneously. Definitive operative management was necessary for removal of filter struts from the aorta, the second part of the duodenum and the iliopsoas muscle. Drainage and debridement of an associated iliopsoas abscess was performed, followed by aortic and caval reconstruction.

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