Enfisema subcutáneo generalizado más neumotórax a tensión posterior a CPRE

Endoscopic retrograde cholangiography (ERCP) is an invasive technique that allows diagnosing and treating pathologies of the bile duct. The rate of complications is low returning to the safe procedure, not free of complications such as pancreatitis, bleeding, cholangitis and even perforation (incide...

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Detalles Bibliográficos
Autores: Anchundia Pico, José, Abarca, Jaysoom, Tulcanazo, Fabián
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2017
País:Ecuador
Institución:Universidad Central del Ecuador
Repositorio:Revista Ciencias Médicas
Idioma:español
OAI Identifier:oai:revistadigital.uce.edu.ec:article/1508
Acceso en línea:https://revistadigital.uce.edu.ec/index.php/CIENCIAS_MEDICAS/article/view/1508
Access Level:acceso abierto
Palabra clave:colangiografía retrograda endoscópica CPRE
neumotórax
enfisema subcutáneo
neumoretroperitoneo
perforación
ERCP
pneumothorax
subcutaneous emphysema
drilling
Descripción
Sumario:Endoscopic retrograde cholangiography (ERCP) is an invasive technique that allows diagnosing and treating pathologies of the bile duct. The rate of complications is low returning to the safe procedure, not free of complications such as pancreatitis, bleeding, cholangitis and even perforation (incidence less than 1.5%). We present the clinical case of a male patient, with pain in the right hypochondrium, vomiting and fever that presents dilatation of the distal end of the common bile duct due to lithiasic cause evidenced by cholangioresonance. It is programmed for CPR, trying cannulation without papillotomy; During the procedure, the patient presents subcutaneous emphysema and tension pneumothorax, requiring emergency treatment. Surgical management was decided twelve hours after ERCP due to the marked hemodynamic instability of the patient; In the intraoperative period and in a subsequent endoscopy, there was no evidence of a macroscopic lesion that justified the clinical and radiological images presented by the patient. Surgical treatment of duodenal perforation wasperformed, which forced a stay in intensive therapy for 11 days. It is complemented by a bibliographic review of post-ERCP complications.