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Papillary injuries and duodenal perforation during endoscopic retrograde sphincterotomy (ERS): radiological findings
O Catalano1, G Lapiccirella, A Rotondo
1Department of Radiological Sciences, University Federico II, Bari, Italy.
Objective:
To describe the radiological features of duodenal injury during endoscopic retrograde sphincterotomy (ERS) with special reference to limited papillary trauma and minor perforation.
Methods:
The radiological and clinical features of duodenal injuries out of 284 ERS performed in the last 4 years were evaluated retrospectively to document various patterns of trauma and correlation with clinical outcome.
Results:
Duodenal injuries occurred in eight patients: mild papillary injuries in five subjects (intrapapillary extravasation of contrast medium in one, peri-Vaterian submucosal diffusion in four) and duodenal perforation in three (peri-choledochal diffusion in one, retroperitoneal leakage in two).
Conclusion:
The radiological findings in papillary and duodenal injuries are protean and knowledge of their variable appearance is important since their detection may have practical consequences.