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Retroperitoneal perforation during endoscopic sphincterotomy: imaging findings
R Zissin1, M Shapiro-Feinberg, A Oscadchy
1Department of Diagnostic Imaging, Meir Hospital, Sapir Medical Center, Kfar Saba, Israel.
Abdominal Imaging
|May 24, 2000
Summary
Retroperitoneal perforation is a rare complication of endoscopic sphincterotomy. Imaging studies like abdominal radiographs and CT scans are crucial for early recognition and management of this serious condition.
Area of Science:
- Gastroenterology
- Radiology
Background:
- Endoscopic retrograde cholangiopancreatography with sphincterotomy is vital for biliary and pancreatic diseases.
- Rare but serious complications can arise, necessitating prompt identification and treatment.
Purpose of the Study:
- To review imaging findings in patients with retroperitoneal perforation post-endoscopic sphincterotomy.
Main Methods:
- Retrospective analysis of 796 patients undergoing endoscopic sphincterotomy over 9 years.
- Assessed imaging findings and clinical outcomes in 9 patients who developed retroperitoneal perforation.
Main Results:
- Retroperitoneal air on abdominal radiographs was seen in 8 patients; contrast extravasation in 6.
- Computed tomography (CT) confirmed findings in 3 patients and diagnosed the ninth patient.
- Two patients succumbed to sepsis.
Conclusions:
- Retroperitoneal perforation is a rare (1.13%) complication of endoscopic sphincterotomy.
- Radiography and CT are effective in diagnosing this complication.
- Early recognition via imaging is critical for managing this potentially life-threatening event.