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Case Reports
. 2022 Dec;15(6):1179-1184.
doi: 10.1007/s12328-022-01699-1. Epub 2022 Sep 12.

A case of endoscopic retrograde cholangiopancreatography-related main pancreatic duct perforation salvaged by endoscopic ultrasonography-guided pancreatic duct drainage

Ryosuke Sato  1 , Kazuyuki Matsumoto  2 , Akihiro Matsumi  1 , Kosaku Morimoto  1 , Hiroyuki Terasawa  1 , Yuki Fujii  1 , Tatsuhiro Yamazaki  1 , Koichiro Tsutsumi  1 , Shigeru Horiguchi  1 , Hironari Kato  1
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Free article
Case Reports

A case of endoscopic retrograde cholangiopancreatography-related main pancreatic duct perforation salvaged by endoscopic ultrasonography-guided pancreatic duct drainage

Ryosuke Sato et al. Clin J Gastroenterol. 2022 Dec.
Free article

Abstract

We herein report a 78-year-old man who underwent endoscopic retrograde cholangiopancreatography (ERCP) to examine main pancreatic duct (MPD) stenosis. During ERCP, MPD perforation occurred due to the cytology brush maneuver. Endoscopic pancreatic stenting to bridge the perforated site failed because the MPD was bent and formed a loop. Thus, we placed the stent at the proximal perforated side. The patient developed retroperitoneal perforation and pancreatic fistula with infection, showing a worsening condition. Pancreatic duct drainage was not effective, so we performed endoscopic ultrasonography-guided pancreatic duct drainage. Subsequently, he gradually improved and was discharged 3 months after initial ERCP.

Keywords: ERCP-related perforation; EUS-guided pancreatic duct drainage; Pancreatic duct perforation.

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