Rare complications of endoscopic retrograde cholangiopancreatography: two case reports.

D. D. Kingsley, C. R. Schermer, M. M. Jamal

Research output: Contribution to journalArticle

21 Citations (Scopus)

Abstract

BACKGROUND: Endoscopic retrograde cholangiopancreatography (ERCP) is a diagnostic procedure with several known risks. We present two rarely reported complications of ERCP and sphincterotomy: transverse mesocolon disruption with ischemic colitis and splenic rupture. RESULTS: The first patient, a 54-year-old female, presented one day following ERCP and stent revision for pancreas divisum. She presented with hypotension and abdominal distention. An abdominal computed tomography (CT) showed a ruptured spleen, which was confirmed on laparotomy. She had a complicated postoperative course and died of multiple organ failure. The second patient is a 56-year-old female who presented five days after ERCP and sphincterotomy with abdominal pain, abdominal wall ecchymosis, and decreasing hematocrit. Her evaluation included hospital admission and abdominal CT scan, which showed free fluid and a large hematoma in the transverse mesocolon. These findings were confirmed on laparotomy and a devascularized segment of bowel was resected. CONCLUSION: Only 6 cases of ERCP-related splenic injury have been reported in the literature. One additional report is available of a fatal splenic artery injury. No previous reports exist of a mesenteric hematoma resulting in bowel devascularization. Prompt evaluation and awareness of potential complications should help capture potentially life-threatening sequelae of ERCP.

Original languageEnglish (US)
Pages (from-to)171-173
Number of pages3
JournalJSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons
Volume5
Issue number2
StatePublished - 2001
Externally publishedYes

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Endoscopic Retrograde Cholangiopancreatography
Mesocolon
Hematoma
Laparotomy
Tomography
Splenic Rupture
Ischemic Colitis
Ecchymosis
Splenic Artery
Multiple Organ Failure
Wounds and Injuries
Abdominal Wall
Hematocrit
Hypotension
Abdominal Pain
Stents
Pancreas
Spleen

Cite this

Rare complications of endoscopic retrograde cholangiopancreatography : two case reports. / Kingsley, D. D.; Schermer, C. R.; Jamal, M. M.

In: JSLS : Journal of the Society of Laparoendoscopic Surgeons / Society of Laparoendoscopic Surgeons, Vol. 5, No. 2, 2001, p. 171-173.

Research output: Contribution to journalArticle

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