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Incidence, Clinical Presentation and Management of Type IV Perforations After Sphincterotomy Among Post Ercp Patients

Intikhab Maqbool*, Asif Rafiq, Meenu chaudhary1, S. A. Kadla1

ERCP related perforation is an endoscopic emergency. Presence of retroperitoneal air after ERCP always is not an indication for emergency surgery. Aim of this study is to determine the incidence of Type IV perforations and management of patients with Type IV perforation.

Methods

This is a prospective hospital based study, in these study 111 consecutive patients after fulfilling the inclusion and exclusion criteria were enrolled.

Results

Incidence of Type IV perforation in the study is 7.2%. All patients with Type IV perforation were managed conservatively.

Conclusion

ERCP related Type IV perforations occur in a significant number of patients undergoing ERCP. Patients in whom an ERCP related perforation is suspected should undergo an urgent CECT abdomen with oral contrast to rule out extravasation of contrast. Patients with contrast extravasation should be managed by emergency surgery. Patients with type IV perforation should be managed conservatively.