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A Primary Repair with Hemoclips and Fibrin Glue Injection in Biliary Stent Induced Duodenal Perforation  

Kim, Ki-Won (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Tae-Hoon (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Park, Sang-Heum (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Son, Bum-Suk (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Sae-Hwan (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Lee, Suck-Ho (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Chung, Il-Kwun (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Kim, Sun-Joo (Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine)
Publication Information
Clinical Endoscopy / v.42, no.6, 2011 , pp. 437-441 More about this Journal
Abstract
Duodenal perforations caused by biliary prostheses are uncommon, but they are potentially life threatening and require immediate treatment. Here we describe an unusual case of duodenal perforation induced by a plastic biliary stent. It masqueraded as a case of cholecystitis and combined systemic upset with a localized peritonitis and fever. Primary endoscopic closure by hemoclips was difficult due to the position of the lateral wall and the complexity of aligning the perforation with the endoscope. To approximate the perforated hole and adherent hemoclips, glue injection and sprayings were successfully performed under cap-fitted endoscopy. The patient recovered without additional complications.
Keywords
Endoscopic retrograde cholangiopancreatography (ERCP); Biliary stent; Intestinal perforation; Hemoclip; Glue injection;
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