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Endoscopic duodenal perforation: Surgical strategies in a regional centre

Citation

Turner, RC and Steffen, CM and Boyd, P, Endoscopic duodenal perforation: Surgical strategies in a regional centre, World Journal of Emergency Surgery, 9, (1) pp. 1-7. ISSN 1749-7922 (2014) [Refereed Article]


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Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0) http://creativecommons.org/licenses/by/2.0/

DOI: doi:10.1186/1749-7922-9-11

Abstract

Background: Duodenal perforation is an uncommon complication of endoscopic retrograde cholangio-pancreatography (ERCP) and a rare complication of upper gastrointestinal endoscopy. Most are minor perforations that settle with conservative management. A few perforations however result in life-threatening retroperitoneal necrosis and require surgical intervention. There is a relative paucity of references specifically describing the surgical interventions required for this eventuality.

Methods: Five cases of iatrogenic duodenal perforation were ascertained between 2002 and 2007 at Cairns Base Hospital. Clinical features were analyzed and compared, with reference to a review of ERCP at that institution for the years 2005/2006.

Results: One patient recovered with conservative management. Of the other four, one died after initial laparotomy. The other three survived, undergoing multiple procedures and long inpatient stays.

Conclusions: Iatrogenic duodenal perforation with retroperitoneal necrosis is an uncommon complication of endoscopy, but when it does occur it is potentially life-threatening. Early recognition may lead to a better outcome through earlier intervention, although a protracted course with multiple procedures should be anticipated. A number of surgical techniques may need to be employed according to the individual circumstances of the case.

Item Details

Item Type:Refereed Article
Keywords:duodenum, endoscopy, necrosis, perforation, surgery
Research Division:Medical and Health Sciences
Research Group:Clinical Sciences
Research Field:Surgery
Objective Division:Health
Objective Group:Clinical Health (Organs, Diseases and Abnormal Conditions)
Objective Field:Surgical Methods and Procedures
Author:Turner, RC (Professor Richard Turner)
ID Code:95887
Year Published:2014
Web of Science® Times Cited:3
Deposited By:Medicine (Discipline)
Deposited On:2014-10-09
Last Modified:2015-04-21
Downloads:221 View Download Statistics

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