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Retained stone retrieval basket causing chronic pancreatitis: a case report.
James Wai Kit Lee1,2,3, Ming Yuan Tan4, Calvin Koh5
1Department of Surgery, National University Hospital, Singapore, Singapore.
Frontiers in Surgery
|August 25, 2023
Summary
Retained endoscopic retrograde cholangiopancreatography (ERCP) instruments, like stone extraction baskets, can cause severe pancreatitis. Prompt removal of foreign bodies is crucial to prevent serious complications such as portal vein thrombosis.
Area of Science:
- Gastroenterology
- Endoscopic procedures
- Pancreatic diseases
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is frequently used for gallstone-related conditions.
- While generally safe, ERCP carries risks, including complications from retained instruments.
- Impacted Dormia baskets are rare but documented ERCP complications.
Purpose of the Study:
- To report a case of recurrent pancreatitis caused by a retained stone extraction basket.
- To emphasize the importance of complete foreign body retrieval during ERCP.
Main Methods:
- A 40-year-old male patient with recurrent pancreatitis underwent imaging (X-ray, CT, MRI) and endoscopy.
- Endoscopy revealed a retained stone extraction basket from a prior ERCP.
- The foreign body was removed, and the patient received anticoagulation for portal vein thrombosis.
Main Results:
- A retained stone extraction basket was identified as the cause of recurrent acute-on-chronic pancreatitis.
- Successful removal of the foreign body was achieved.
- The patient developed portal vein thrombosis secondary to pancreatitis, requiring anticoagulation.
Conclusions:
- Retained foreign bodies, particularly in the pancreatic head, pose a significant risk.
- Complete retrieval of all instruments after ERCP is essential to prevent long-term complications.
- Early identification and removal of retained ERCP material can mitigate severe outcomes.
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