Clinical Endoscopy

The Korean Society of Gastrointestinal Endoscopy (대한소화기내시경학회)
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Four Cases of Guidewire Induced Periampullary Perforation During Endoscopic Retrograde Cholangiopancreatography

내시경 역행성 담췌관조영술 중 발생한 유도선에 의한 유두부주위 천공 4예

  • Lee, Tae-Hoon (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Park, Sang-Heum (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Son, Bum-Suk (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Jun, Baek-Gyu (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Eun, Jun-Young (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Jae-Yun (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Lee, Sae-Hwan (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine) ;
  • Kim, Sun-Joo (Department of Internal Medecine, Cheonan Hospital, Soonchunhyang University College of Medicine)
  • 이태훈 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 박상흠 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 손범석 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 전백규 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 은준영 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 김재연 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 이세환 (순천향대학교 의과대학 천안병원 내과학교실) ;
  • 김선주 (순천향대학교 의과대학 천안병원 내과학교실)
  • Published : 2011.05.30
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Abstract

Duodenal perforation associated with endoscopic retrograde cholangiopancreatography is very uncommon. However, it usually requires early diagnosis and surgical management. Perforations are commonly caused by endoscopic sphincterotomy, biliary or duodenal stent placement, guidewire-related causes, and endoscopy itself. Perforatioins can follow various clinical courses, and management depends on the cause of the perforation. Among the above causes, guidewire- induced perforation is very rare and related reports and analyses are limited. Herein we describe four cases of guidewire-induced periampullary perforation during endoscopic retrograde cholangiopancreatography, and analyze clinical characteristics and management.

내시경 역행성 담췌관조영술시 유도선에 의한 장 천공은 약 0.12~0.19%로 비교적 드문 합병증이나 조기 진단 지연시 치명적인 결과를 초래할 수 있다. 장 천공의 발생은 유두괄약근절개, 배액관 삽입 시술 중 발생할 수 있고, 내시경 기구 자체에 의해서도 발생하며 원인에 따른 치료와 임상 경과도 다양하다. 그러나 유도선에 의한 장 천공의 경우는 매우 드물어 임상경과 및 치료에 대한 보고나 고찰이 제한적이다. 저자들은 담췌관조영술 시행 중 선택적 담도 삽관이 어려워 예비절개술을 시행한 환자들에서 유도선에 의한 장 천공을 조기에 확진하고 치료한 4예를 문헌 고찰과 함께 보고한다.

Keywords

References

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