A Case of Pneumoretroperitoneum, Pneumomediastinum, and Subcutaneous Emphysema after Endoscopic Sphincterotomy.
- Author:
Jun Hee LEE
1
;
Se Joon LEE
;
Jun Pyo CHUNG
;
Woon Hyoung PARK
;
Won Tae SEO
;
Ki Joon HAN
;
Hyo Jin PARK
;
Si Young SONG
;
Kwan Sik LEE
;
Jae Bock CHUNG
;
Sang In LEE
;
Jin Kyung KANG
Author Information
1. Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Case Report
- Keywords:
Endoscopic sphincterotomy;
Perforation;
Pneunomediastinum;
Subcutaneous emphysema
- MeSH:
Aged, 80 and over;
Anti-Bacterial Agents;
Drainage;
Female;
Gastrectomy;
Gastroenterostomy;
Humans;
Mediastinal Emphysema*;
Retropneumoperitoneum*;
Sphincterotomy, Endoscopic*;
Subcutaneous Emphysema*
- From:Korean Journal of Gastrointestinal Endoscopy
2000;21(2):676-679
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
Perforation complicates endoscopic sphincterotomy (EST) in approximately 1% of cases. However, pneunomediastinum and/or subcutaneous emphysema due to duodenal perforation after EST have rarely been reported. The management strategy of this awkward complication of EST remains controversial. Conservative treatment with antibiotics and nasogastric and/or biliary drainage has been reported to be adequate, but some authors still advocate early surgery for all perforations. Therefore, it seems necessary to accumulate more data in order to set up a management algorithm in these cases. Recently, we experienced a case of pneumoretroperitoneum, pneumomediastinum, and subcutaneous emphysema developed after EST and stone removal in which recovery was achieved with conservative treatment in a 87-year-old woman with previous Billroth II partial gastrectomy. We herein report this rare complication of EST and a management algorithm is suggested based on a literature review.
