Sphincterotomy Related Perforations Diagnosed by CT: Incidence, Risk Factors and Outcome

Of all the gastrointestinal endoscopic interventional techniques, endoscopic retrograde cholangiopancreatography (ERCP) recorded the highest rate of complications with great variability. These include pancreatitis, bleeding, cholangitis and perforation. Despite its low incidence, ranging from 0.3% to 1.3%, duodenal perforation occurring during ERCP has been shown to cause high mortality of 16–18%. 

Several classifications of ERCP-related perforations have been published in the medical literature and management guidelines based on clinical and radiological criteria have been developed. However, the management of ERCP related perforations remains controversial: conservative versus early operative treatment. There is no doubt that early and accurate diagnosis of perforations cannot be underestimated. It has been proposed that delayed diagnosis may result in dire outcome. Abdominal computerized tomography (CT) is considered the best modality for the diagnosis of perforations. Read more>>>>>>>>>>>>>