Papillary injuries and duodenal perforation during endoscopic retrograde sphincterotomy (ERS): radiological findings.

OBJECTIVE

To describe the radiological features of duodenal injury during endoscopic retrograde sphincterotomy (ERS) with special reference to limited papillary trauma and minor perforation.

METHODS

The radiological and clinical features of duodenal injuries out of 284 ERS performed in the last 4 years were evaluated retrospectively to document various patterns of trauma and correlation with clinical outcome.

RESULTS

Duodenal injuries occurred in eight patients: mild papillary injuries in five subjects (intrapapillary extravasation of contrast medium in one, peri-Vaterian submucosal diffusion in four) and duodenal perforation in three (peri-choledochal diffusion in one, retroperitoneal leakage in two).

CONCLUSION

The radiological findings in papillary and duodenal injuries are protean and knowledge of their variable appearance is important since their detection may have practical consequences.