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Related Experiment Video

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Catheterization of Intestinal Loops in Ruminants
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A dangerous loop.

Saqib Ahmad1, Damian Bragg2, Abed M Zaitoun3

  • 1Gastroenterology National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK.

Clinical Case Reports
|May 19, 2016
PubMed
Summary
This summary is machine-generated.

A rare complication of endoscopic retrograde cholangiopancreatography (ERCP) is splenic injury, leading to hemoperitoneum. This case highlights a potential mechanism involving endoscope manipulation causing splenic capsular tears.

Keywords:
Adverse eventERCPhemorrhageimagingsplenic injurysurgery

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Area of Science:

  • Gastroenterology
  • Surgical Complications

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for biliary and pancreatic diseases.
  • Choledocholithiasis, the presence of gallstones in the common bile duct, is a frequent indication for ERCP.

Purpose of the Study:

  • To report a rare case of splenic injury following ERCP for choledocholithiasis.
  • To discuss the potential mechanism of iatrogenic splenic injury during ERCP.

Main Methods:

  • Case report of a 76-year-old male patient.
  • Review of the patient's clinical course, including ERCP procedure and subsequent surgical intervention.

Main Results:

  • The patient developed hemoperitoneum after ERCP.
  • A splenic capsular tear at the hilum was identified as the cause, necessitating laparotomy and splenectomy.
  • A plausible mechanism involving endoscope "bowing" and torsion leading to shear forces on the spleen was proposed.

Conclusions:

  • Splenic injury is a rare but serious complication of ERCP.
  • Endoscopic manipulation, specifically "bowing" and torsion, may induce shear forces resulting in splenic injury.