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]
Licensed under Creative Commons Attribution 2.0 Generic (CC BY 2.0) http://creativecommons.org/licenses/by/2.0/
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 Type:||Refereed Article|
|Keywords:||duodenum, endoscopy, necrosis, perforation, surgery|
|Research Division:||Medical and Health Sciences|
|Research Group:||Clinical Sciences|
|Objective Group:||Clinical Health (Organs, Diseases and Abnormal Conditions)|
|Objective Field:||Surgical Methods and Procedures|
|UTAS Author:||Turner, RC (Professor Richard Turner)|
|Web of Science® Times Cited:||6|
|Downloads:||250 View Download Statistics|
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