Andrzej Żyluk, Wojciech Jagielski


We present the case of a 25-year-old patient who had sphincterotomy performed for the retrieval of gall stones form the common bile duct, and in whom, immediately after the procedure, signs and symptoms of the retroperitoneal, iatrogenic perforation of the duodenum had developed. Additionally, the patient showed clinical and biochemical symptoms of acute pancreatitis. The patient was operated on, and, intraoperatively, the duodenal perforation was not found, but excessive inflammatory infiltration of the retroperitoneal space, without bile leakage, and typical features for acute pancreatitis. The operation was confined to the duodenal and retroperitoneal space exposure, drainage and jejunostomy for nourishment. The postoperative course was uneventful, acute pancreatitis did not develop into the necrotising form, and the patient eventually recovered.


duodenum perforation; acute pancreatitis; complications; endoscopic retrograde cholangiopancreatography

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Motomura Y., Akahoshi K., Gibo J., Kanayama K., Fukuda S., Hamada S. et al.: Immediate detection of endoscopic retrograde cholangio-pancreatography-related periampullary perforation: fluoroscopy or endoscopy? World J Gastroenterol. 2014, 20 (42), 797–804.

Cho K.B.: The management of endoscopic retrograde cholangiopancreatography-related duodenal perforation. Clin Endosc. 2014, 47 (4), 341–345.

Turner R.C., Steffen C.M., Boyd P.: Endoscopic duodenal perforation: surgical strategies in a regional centre. World J Emerg Surg. 2014, 9 (1), 5–11.

Pannu H.K., Fishman E.K.: Complications of endoscopic retrograde cholangiopancreatography: spectrum of abnormalities demonstrated with CT. Radiographics. 2001, 21 (6), 1441–1453.

Masci E., Toti G., Mariani A., Curioni S., Lomazzi A., Dinelli M. et al.: Complications of diagnostic and therapeutic ERCP: a prospective multicenter study. Am J Gastroenterol. 2001, 96 (2), 417–423.

Vowinkel T., Senninger N.: Retroperitoneal emphysema after endoscopic retrograde cholangiopancreatography. Chirurg. 2015, 86 (5), 426–467.

Iorgulescu A., Sandu I., Turcu F., Iordache N.: Post-ERCP acute pancreatitis and its risk factors. J Med Life. 2013, 15 (6), 109–113.

Chen Z.B., Liang Z.Y., Zhang Y., Zhang S.Y., Zheng S.S.: Surgical intervention of severe post-ERCP-pancreatitis accompanied with duodenum perforation. J Zhejiang Univ Sci B. 2010, 11 (1), 17–21.

Klimczak J., Markert R.: Retrospective analysis of post-endoscopic retrograde cholangio-pancreatography mortalities. Pol Merkur Lekarski. 2003, 15, 199–201.

Peterlejtner T., Szewczyk T., Firkowski P., Zdrojewski M.: Endoscopic treatment of the choledocholithiasis – effectiveness, safety and limitations of the method. Pol Przegl Chir. 2012, 84 (7), 333–340.

Jin Y.J., Jeong S., Kim J.H., Hwang J.C., Yoo B.M., Park S.H. et al.: Clinical course and proposed treatment strategy for ERCP-related duodenal perforation: a multicenter analysis. Endoscopy. 2013, 45 (10), 806–812.


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