내시경적 유두괄약근 절개술후 발생한 기종격증 및 피하기종

• Published in: The Korean journal of gastroenterology Vol. 29; no. 3; pp. 399 - 403
• Main Authors: 조영덕, Young Deok Cho, 봉형근, Hyung Keun Bong, 김진오, Jin Oh Kim, 조주영, Joo Young Cho, 김연수, Yun Soo Kim, 이준성, Joon Seong Lee, 이문성, Moon Sung Lee, 황성규, Seong Gyu Hwang, 심찬섭, Chan Sup Shim
• Format: Journal Article
• Language: Korean
• Published: 대한소화기학회 01.01.1997
• Subjects: EST; Perforation; Pneumomediastinum; Subcutaneous emphysema
• ISSN: 1598-9992

Perforation, bleeding, cholangitis, and pancreatitis are common complications of endoscopic sphincterorny(EST) that is considered a common effective method for treatment of distal bile duct obstruction and removal of bile duct stones. Perforation of duodenutn complicates endoscopic sphincterotomy in approximately 1% of cases. But, retroperitoneal, mediastinal and subcutaneous emphysema are very rare complications of endoscopic sphincterotomy. A 50-year-old woman was admitted to our hospital due to right upper quadrant abdominal pain for 1 week. An ERCP revealed markdly dilated commom bile duct and rnultiple ductal filling defects. For removal of' stones, EST was performed with pull type papillotome. About 1 hour later after procedure, she complained of chest pressure, shortness of breath and abdominal distension. The chest X-ray film revealed a pneumomediastinum, segmental atelectasis of left lower lung fields and subcutaneous emphysema. The simple abdominal X-ray showed mottled air densities in the right midabdomen and crescentic air densities in the right perirenal space. We report on a rare case of retroperitoneal duodenal perforation, pneumomediastinum and subcutaneous emphyserna following endoscopic sphinctero- tomy, in a patient with common bile duct stones. (Korean J Gastroenterol 1997; 29:399-403)