HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Figures Only Full Text Full Text (PDF) CME Test (opens in a new window) Submit a response Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Pannu, H. K. Articles by Fishman, E. K. Search for Related Content PubMed PubMed Citation Articles by Pannu, H. K. Articles by Fishman, E. K. Related Collections Computed Tomography Gastrointestinal Radiology

Complications of Endoscopic Retrograde Cholangiopancreatography: Spectrum of Abnormalities Demonstrated with CT¹

¹ From the Russell H. Morgan Department of Radiology and Radiological Science, Johns Hopkins University, Baltimore, Md. Presented as a scientific exhibit at the 1999 RSNA scientific assembly. Received April 18, 2000; revision requested June 21; final revision received May 3, 2001; accepted May 3. Address correspondence to H.K.P., Department of Radiology, Johns Hopkins Hospital, 600 N Wolfe St, Baltimore, MD 21287 (e-mail: hpannu@jhmi.edu).

Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive procedure that is performed to diagnose and treat pancreatic and biliary disease. In approximately 5%–10% of cases, the procedure itself causes adverse events. Diagnosis and management of ERCP-induced complications are performed with clinical, laboratory, and radiologic procedures. Evaluation of the type and severity of the complication is necessary and is successfully performed with computed tomography (CT). The most common causes of post-ERCP pain are acute pancreatitis and duodenal perforation. In severe pancreatitis, the pancreas is enlarged and enhances heterogeneously at CT. Pancreatic enhancement is diminished in areas of glandular necrosis. In duodenal perforation, CT may reveal extraluminal air or fluid. CT findings of acute duodenal hemorrhage are duodenal wall thickening and a high-attenuation mass in the duodenal wall. In infection, the bile ducts can be dilated and the attenuation of the bile can be increased at CT. Abscesses appear as hypoattenuating masses with enhancing capsules. CT findings of stent migration are an atypical location of the stent and bowel impaction. Other complications of ERCP are those related to endoscopy and include esophageal, liver, and splenic injury.

Index Terms: Bile ducts, stents and prostheses, 76.46 • Cholangitis, 76.20 • Duodenum, hemorrhage, 73.412 • Duodenum, perforation, 73.715 • Endoscopic retrograde cholangiopancreatography (ERCP), 70.1222 • Endoscopy, 70.458 • Pancreatitis, 770.291

This article has been cited by other articles:

				P. D. Thurley and R. Dhingsa Laparoscopic Cholecystectomy: Postoperative Imaging Am. J. Roentgenol., September 1, 2008; 191(3): 794 - 801. [Abstract] [Full Text] [PDF]

				A. Assalia, A. Suissa, A. Ilivitzki, A. Mahajna, K. Yassin, M. Hashmonai, and M. M. Krausz Validity of Clinical Criteria in the Management of Endoscopic Retrograde Cholangiopancreatography Related Duodenal Perforations Arch Surg, November 1, 2007; 142(11): 1059 - 1064. [Abstract] [Full Text] [PDF]

				R. Badaoui, M. Ouendo, R. Delcenserie, C. El Kettani, M. Radji, and M. Ossart Injury to the liver and spleen after diagnostic ERCP Can J Anesth, August 1, 2002; 49(7): 756 - 757. [Full Text]