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内镜逆行胰胆管造影术后并发症:一例十二指肠穿孔病例及文献综述

Post-endoscopic Retrograde Cholangiopancreatography Complications: A Case of Duodenal Perforation and Literature Review.

作者信息

Dufera Rabira R, Berake Tamiru B, Maliakkal Benedict

机构信息

Internal Medicine, Meharry Medical College, Nashville, USA.

Internal Medicine, Tufts Medical Center, Boston, USA.

出版信息

Cureus. 2023 Jun 12;15(6):e40303. doi: 10.7759/cureus.40303. eCollection 2023 Jun.

Abstract

A duodenal perforation is a serious complication that can occur during endoscopic retrograde cholangiopancreatography (ERCP), particularly if it is associated with therapeutic endoscopic sphincterotomy. Therefore, it is crucial to identify and manage it early to achieve the best possible outcome. Conservative management may be attempted; however, surgical intervention is required if signs of sepsis or peritonitis are present. In this case report, we present the case of post-ERCP duodenal perforation in a 33-year-old female with sickle cell disease who presented on account of abdominal pain. The patient was diagnosed with post-ERCP duodenal perforation, type 4 according to the Stapfer classification. She was subsequently treated conservatively with intravenous antibiotics, bowel rest, and serial abdominal exams. The patient noted significant interval improvement in symptoms and was subsequently discharged home. The early detection and management of suspected complications of ERCP provide a critical prognostic value.

摘要

十二指肠穿孔是一种严重的并发症,可发生在内镜逆行胰胆管造影术(ERCP)期间,尤其是当它与治疗性内镜括约肌切开术相关时。因此,尽早识别并处理至关重要,以实现最佳预后。可尝试保守治疗;然而,如果出现脓毒症或腹膜炎迹象,则需要进行手术干预。在本病例报告中,我们呈现了一名33岁患有镰状细胞病的女性在ERCP术后发生十二指肠穿孔的病例,该患者因腹痛就诊。根据Stapfer分类,该患者被诊断为ERCP术后十二指肠穿孔,4型。随后她接受了静脉抗生素治疗、肠道休息和系列腹部检查等保守治疗。患者症状有明显改善,随后出院回家。ERCP疑似并发症的早期检测和处理具有关键的预后价值。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/39cd/10259486/08afcdd1fae3/cureus-0015-00000040303-i01.jpg

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