The Indian Practitioner

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Management of Post-ERCP Air Leak: A Case Report


Affiliations
1 Department of Gastroenterology, IGMC - Shimla, India
2 Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, India
     

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Endoscopic retrograde cholangiopancreatography (ERCP) is associated with retroperitoneal perforation in approximately 2.1% patients, but not infrequently, retroperitoneal air, pneumoperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema are also reported which may or may not be associated with retroperitoneal perforation. We report the case of a female patient with post-ERCP air leak into different compartments without iatrogenic gastrointestinal perforation and which was managed conservatively.

Keywords

Endoscopic Retrograde Cholangiopancreatography, Contrast Enhanced Computed Tomography, Side Viewing Esophagogastroduodenoscope.
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  • Ferrara F, Luigiano C, Billi P, Jovine E, Cinquantini F, D’Imperio N. Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after ERCP. Gastrointest Endosc 2009; 69:1398-401.

  • Seymann GB, Savides T, Richman KM. Massive subcutaneous emphysema after endoscopic retrograde cholangiopancreatography. Am J Med 2010; 123:e15-6.

  • Kaul S, Koul S, Singh H, Kachroo SL, Chrungoo RK. Post ERCP Surgical Emphysema. J K Science 2008; 10:18990.

  • Stapfer M, Selby RR, Stain SC, et al. Management of duodenal perforation after endoscopic retrograde cholangiopancreatography and sphincterotomy. Ann Surg 2000; 232:191-8.

  • Jaiswal SK, Sreevastava DK, Datta R, Lamba NS. Unusual occurrence of massive subcutaneous emphysema during ERCP under general anaesthesia. Indian J Anaesth 2013; 57:615-7.

  • Seymann GB, Savides T, Richman KM. Massive subcutaneous emphysema after endoscopic retrograde cholangiopancreatography. Am J Med. 2010; 123:e15–6.

  • Kaul S, Koul S, Singh H, Kachroo SL, Chrungoo RK. Post ERCP Surgical Emphysema. J K Science. 2008; 10:18990.


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  • Management of Post-ERCP Air Leak: A Case Report

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Authors

Brij Sharma
Department of Gastroenterology, IGMC - Shimla, India
Rajesh Sharma
Department of Gastroenterology, IGMC - Shimla, India
Vishal Bodh
Department of Gastroenterology, IGMC- Shimla, Himachal Pradesh, India
Rajesh Kumar
Department of Gastroenterology, IGMC - Shimla, India

Abstract


Endoscopic retrograde cholangiopancreatography (ERCP) is associated with retroperitoneal perforation in approximately 2.1% patients, but not infrequently, retroperitoneal air, pneumoperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema are also reported which may or may not be associated with retroperitoneal perforation. We report the case of a female patient with post-ERCP air leak into different compartments without iatrogenic gastrointestinal perforation and which was managed conservatively.

Keywords


Endoscopic Retrograde Cholangiopancreatography, Contrast Enhanced Computed Tomography, Side Viewing Esophagogastroduodenoscope.

References