scholarly journals Endoscopic Retrograde Cholangiopancreatography Leading to Pharyngeal Perforation

2020 ◽  
Vol 14 (1) ◽  
pp. 80-86
Author(s):  
Umair M. Nasir ◽  
Ahmed Ahmed ◽  
Dayna Panchal ◽  
Catherine Choi ◽  
Brandon Rodgers ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Streptococcus Mitis ◽  
Unique Case ◽  
Abscess Drainage ◽  
Endoscopic Retrograde ◽  
Left Neck ◽  
Pharyngeal Perforation ◽  
Invasive Method ◽  
Fluid Collections

Endoscopic retrograde cholangiopancreatography (ERCP) had become the favored method to access the pancreaticobiliary system because it is a safer and less invasive method compared to surgery. However, as with any procedure, ERCP comes with its own risks and potential complications. We present a unique case of a patient who underwent ERCP and developed necrotizing infection of the neck and a submandibular abscess. The patient is a 66-year-old female who presented to an outside hospital with complaint of right upper quadrant abdominal pain, workup of which revealed choledocholithiasis. ERCP was attempted; however, cannulation was unsuccessful. The patient was discharged home after the procedure, but within 48 h she presented to our institution complaining of left-sided neck pain, dysphagia, and drooling. CT of the neck revealed extensive gas and fluid collections at the left submandibular space. The patient was taken to the operating room for drainage of the left neck abscess. Drainage and irrigation of the abscess yielded Streptococcus mitis and Hemophilus parainfluenza. The rest of patient’s hospital course was uncomplicated, and she was discharged with appropriate follow-up. In the case of our patient, ERCP was complicated by a perforation of the hypopharynx. Pharyngeal perforation can be subclassified into supraglottic and infraglottic. The most frequent cause of perforations is due to increased pressure in an intrinsically weak anatomical region of the pharynx. Such perforations are commonly due to the advancement of the endotracheal tube or transthoracic echo probe, but can also be due to advancement of an endoscope.

scholarly journals Difficult Biliary Cannulation in Endoscopic Retrograde Cholangiopancreatography: Definitions, Risk Factors, and Implications

2021 ◽  
pp. 64-72
Author(s):  
Brian M. Fung ◽  
Teodor C. Pitea ◽  
James H. Tabibian
Keyword(s):  
Risk Factors ◽  
Endoscopic Retrograde Cholangiopancreatography ◽  
Significant Progress ◽  
Endoscopic Retrograde ◽  
Biliary Cannulation ◽  
Vast Array ◽  
The Past ◽  
Increased Risk ◽  
Invasive Method ◽  
Difficult Biliary Cannulation

Over the past 50 years, endoscopic retrograde cholangiopancreatography (ERCP) has become the preferred minimally invasive method of treating a vast array of pancreatobiliary diseases. An initial sine qua non for ERCP success is selective ductal cannulation. Despite significant progress in the optimisation of ERCP methods and accessories, selective biliary cannulation using conventional techniques remains unsuccessful in approximately 15% of native papilla cases. Furthermore, difficult biliary cannulation has been associated with an increased risk of post-ERCP pancreatitis, among other adverse events. Here, in the first of a two-part series, the authors provide a primer on standard biliary cannulation techniques and discuss the definition, risk factors, and implications of difficult biliary cannulation. The second part of the series will provide an overview of the existing advanced techniques used in cases of difficult biliary cannulation as well as the approach to their selection.

scholarly journals The Role of Endoscopic Retrograde Cholangiopancreatography (ERCP) in the Management of Intra-Biliary Rupture of Liver Hydatid Cysts (IBRH): Follow-Up of 12 Cases

2014 ◽  
Vol 03 (09) ◽  
pp. 533-543
Author(s):  
Mohammad Abdulrahman Alshekhani ◽  
Taha A. Alkarbuli ◽  
Naser Abdullah Mohammed Alqazi ◽  
Hiwa A. Hussein ◽  
Qalandar H. Kasnazan ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Hydatid Cysts ◽  
Endoscopic Retrograde

scholarly journals A multicenter survey on endoscopic retrograde cholangiopancreatography during the COVID-19 pandemic in northern and central Italy

2021 ◽  
Vol 09 (04) ◽  
pp. E629-E634
Author(s):  
Giulio Donato ◽  
Edoardo Forti ◽  
Massimiliano Mutignani ◽  
Maria Antonella Laterra ◽  
Daniele Arese ◽  
...  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Central Italy ◽  
Similar Rate ◽  
Published Data ◽  
Case Volume ◽  
Endoscopic Retrograde ◽  
Multicenter Survey ◽  
Screening Protocol ◽  
The Impact

Abstract Background and study aims COVID-19 has dramatically impacted endoscopy practice because upper endoscopy procedures can be aerosol-generating. Most elective procedures have been rescheduled. Endoscopic retrograde cholangiopancreatography (ERCP) is frequently performed in emergency or urgent settings in which rescheduling is not possible. We evaluated the impact of the COVID-19 pandemic on ERCP in Italy during the SARS-CoV-2 lockdown, in areas with high incidence of COVID-19. Patients and methods We performed a retrospective survey of centers performing ERCP in high COVID-19 prevalence areas in Italy to collect information regarding clinical data from patients undergoing ERCP, staff, case-volume and organization of endoscopy units from March 8, 2020 to April 30, 2020. Results We collected data from 31 centers and 804 patients. All centers adopted a triage and/or screening protocol for SARS-CoV-2 and performed follow-up of patients 2 weeks after the procedure. ERCP case-volume was reduced by 44.1 % compared to the respective 2019 timeframe. Of the 804 patients undergoing ERCP, 22 (2.7 %) were positive for COVID-19. Adverse events occurred at a similar rate to previously published data. Of the patients, endoscopists, and nurses, 1.6 %, 11.7 %, and 4.9 %, respectively, tested positive for SARS-CoV-2 at follow up. Only 38.7 % of centers had access to a negative-pressure room for ERCP. Conclusion The case-volume reduction for ERCP during lockdown was lower than for other gastrointestinal endoscopy procedures. No definitive conclusions can be drawn about the percentage of SARS-CoV-2-positive patients and healthcare workers observed after ERCP. Appropriate triage and screening of patients and adherence to society recommendations are paramount.

scholarly journals Bedside Endoscopic Retrograde Cholangiopancreatography Using Portable X-Ray in Acute Severe Cholangitis

2018 ◽  
Vol 2018 ◽  
pp. 1-3
Author(s):  
Rushikesh Shah ◽  
Emad Qayed
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Acute Cholangitis ◽  
Fluoroscopic Guidance ◽  
Ultrasound Guided ◽  
Unique Case ◽  
Endoscopic Retrograde ◽  
Biliary Decompression ◽  
Biliary Cannulation ◽  
X Ray ◽  
Life Saving

Patients with acute cholangitis require emergent biliary decompression. Those who are hemodynamically unstable on vasopressor support and mechanical ventilation are too critically ill to move outside of the intensive care unit. This prohibits performing Endoscopic Retrograde Cholangiopancreatography (ERCP) in the endoscopy unit. Fluoroscopic guidance is required to confirm deep biliary cannulation during ERCP. There are a few reported cases of bedside ERCP using portable C-arm fluoroscopy unit or ultrasound guided cannulation. We present a unique case of life-saving emergent bedside ERCP in a severely ill patient with cholangitis and septic shock, using simple portable X-ray to confirm biliary cannulation.

scholarly journals Endoscopic closure of duodenal perforation post-endoscopic retrograde cholangiopancreatography: A case report

2021 ◽  
Vol 2 (5) ◽  
Author(s):  
Ramin Niknam ◽  
◽  
Gholam Reza Sivandzadeh ◽  
Keyword(s):  
Endoscopic Retrograde Cholangiopancreatography ◽  
Common Bile Duct Stones ◽  
Duodenal Perforation ◽  
Endoscopic Retrograde ◽  
Endoscopic Repair ◽  
Case Presentation ◽  
Surgical Interventions ◽  
Endoscopic Closure ◽  
Endoscopic Clips

Background: Duodenal perforation post - Endoscopic Retrograde Cholangiopancreatography (ERCP) is uncommon, but if not treated well enough in time, it can have serious consequences. There are few reports that endoscopic-related duodenal perforation has been successfully treated using endoclips. Case presentation: A 63-year-old woman was referred for ERCP because of cholestatic jaundice caused by common bile duct stones. During the procedure, duodenal perforation post-ERCP was suggested. The endoscopic repair of the perforation was performed immediately using 5 endoscopic clips. Antibiotic therapy was also started and clinical and radiological follow-up was performed. Patient condition was good immediately after surgery and during hospitalization. Conclusion: Endoscopic treatment of duodenal perforation postERCP can be suggested as a treatment option in highly selected patients which may lead to a reduction in the frequency of surgical interventions. Keywords: endoscopic retrograde cholangiopancreatography; endoscopy; perforation; endoscopic clips.

Sign in / Sign up

Export Citation Format

Share Document