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[A retroperitoneal abscess after endoscopic sphincterotomy: a severe and infrequent complication]
F J Fernández Pérez1, J M Martín Guerrero, H Pallarés Manrique
1Servicio de Aparato Digestivo, Hospital Virgen de la Macarena, Sevilla.
Revista Espanola De Enfermedades Digestivas
|February 1, 1997
Summary
Endoscopic sphincterotomy can cause duodenal perforation, a rare but serious complication. Prompt surgical intervention is crucial for infected collections to prevent high mortality rates.
Area of Science:
- Gastroenterology
- Surgical Complications
Background:
- A 55-year-old female, post-cholecystectomy, presented with recurrent biliary pain, cholestasis, and common bile duct dilation.
- Initial management included endoscopic sphincterotomy for biliary obstruction.
Observation:
- Post-procedure, the patient developed abdominal pain and fever, indicating a complication.
- CT scan revealed retroperitoneal air and an infected fluid collection.
Findings:
- Percutaneous drainage was attempted but proved insufficient due to low outflow.
- Surgical treatment became necessary due to persistent symptoms and infected material.
Implications:
- Duodenal perforation is an uncommon but severe complication of endoscopic sphincterotomy.
- Prompt surgical management is essential for infected collections to reduce high mortality.
- While some retropneumoperitoneum cases resolve conservatively, infected collections necessitate immediate surgical intervention.