Korean J Gastrointest Endosc > Volume 42(6); 2011 > Article
Korean Journal of Gastrointestinal Endoscopy 2011;42(6): 437-441.
담도 스텐트 이탈에 의한 십이지장 천공 환자에서 지혈클립과 Fibrin Glue를 이용한 내시경 치료 1예
순천향대학교 의과대학 천안병원 소화기내과학교실
A Primary Repair with Hemoclips and Fibrin Glue Injection in Biliary Stent Induced Duodenal Perforation
Ki Won Kim, M.D., Tae Hoon Lee, M.D., Sang-Heum Park, M.D., Bum Suk Son, M.D., Sae Hwan Lee, M.D., Suck-Ho Lee, M.D., Il-Kwun Chung, M.D. and Sun-Joo Kim, M.D.
Department of Internal Medicine, Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
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.
Key Words: Endoscopic retrograde cholangiopancreatography (ERCP), Biliary stent, Intestinal perforation, Hemoclip, Glue injection
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