Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report
Abstract Endoscopic ultrasound‐guided biliary drainage (EUS‐BD) has become popular as a new drainage technique for malignant biliary strictures. Although EUS‐BD has been reported to show high technical and clinical success rates, the rate of adverse events is 15%. In particular, peritonitis, which i...
| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2022-04-01
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| Series: | DEN Open |
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| Online Access: | https://doi.org/10.1002/deo2.77 |
| _version_ | 1828290436536467456 |
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| author | Yukitaka Yasuhara Nana Shimamoto Shintaro Tsukinaga Masayuki Kato Kazuki Sumiyama |
| author_facet | Yukitaka Yasuhara Nana Shimamoto Shintaro Tsukinaga Masayuki Kato Kazuki Sumiyama |
| author_sort | Yukitaka Yasuhara |
| collection | DOAJ |
| description | Abstract Endoscopic ultrasound‐guided biliary drainage (EUS‐BD) has become popular as a new drainage technique for malignant biliary strictures. Although EUS‐BD has been reported to show high technical and clinical success rates, the rate of adverse events is 15%. In particular, peritonitis, which is generally caused by bile leakage from the aspiration side during the procedure and occurs within a few days after EUS‐BD, needs to be considered as it can be fatal. In the present case, a jaundiced patient presented with unresectable pancreatic adenocarcinoma. Due to duodenal invasion, we performed EUS‐guided hepaticogastrostomy for biliary drainage. After the procedure, jaundice improved, and abdominal computed tomography (CT) showed only a small amount of air in the intrahepatic bile duct. However, 7 days after the procedure, the patient developed fever, and clinical findings indicated peritonitis. Abdominal CT showed food in the stomach accompanied by the appearance of perihepatic free air, with increased air in the intrahepatic bile duct. The duodenal stent insertion settled the peritonitis and improved the perihepatic free air and the air in the intrahepatic bile duct through the discharge of food from the stomach. To date, no case of tardive peritonitis associated with air leakage after EUS‐BD has been reported. We noted that even if there was no evidence of bile leakage after EUS‐BD, the possibility of tardive peritonitis due to gradual air leakage from the stent implantation side of the stomach should be considered, and careful follow‐up is needed. |
| first_indexed | 2024-04-13T10:36:37Z |
| format | Article |
| id | doaj.art-029464a421564862a9afe508957bed5d |
| institution | Directory Open Access Journal |
| issn | 2692-4609 |
| language | English |
| last_indexed | 2024-04-13T10:36:37Z |
| publishDate | 2022-04-01 |
| publisher | Wiley |
| record_format | Article |
| series | DEN Open |
| spelling | doaj.art-029464a421564862a9afe508957bed5d2022-12-22T02:50:03ZengWileyDEN Open2692-46092022-04-0121n/an/a10.1002/deo2.77Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case reportYukitaka Yasuhara0Nana Shimamoto1Shintaro Tsukinaga2Masayuki Kato3Kazuki Sumiyama4Faculty of Medicine the Jikei University School of Medicine Tokyo JapanDepartment of Endoscopy the Jikei University School of Medicine Tokyo JapanDepartment of Endoscopy the Jikei University School of Medicine Tokyo JapanDepartment of Endoscopy the Jikei University School of Medicine Tokyo JapanDepartment of Endoscopy the Jikei University School of Medicine Tokyo JapanAbstract Endoscopic ultrasound‐guided biliary drainage (EUS‐BD) has become popular as a new drainage technique for malignant biliary strictures. Although EUS‐BD has been reported to show high technical and clinical success rates, the rate of adverse events is 15%. In particular, peritonitis, which is generally caused by bile leakage from the aspiration side during the procedure and occurs within a few days after EUS‐BD, needs to be considered as it can be fatal. In the present case, a jaundiced patient presented with unresectable pancreatic adenocarcinoma. Due to duodenal invasion, we performed EUS‐guided hepaticogastrostomy for biliary drainage. After the procedure, jaundice improved, and abdominal computed tomography (CT) showed only a small amount of air in the intrahepatic bile duct. However, 7 days after the procedure, the patient developed fever, and clinical findings indicated peritonitis. Abdominal CT showed food in the stomach accompanied by the appearance of perihepatic free air, with increased air in the intrahepatic bile duct. The duodenal stent insertion settled the peritonitis and improved the perihepatic free air and the air in the intrahepatic bile duct through the discharge of food from the stomach. To date, no case of tardive peritonitis associated with air leakage after EUS‐BD has been reported. We noted that even if there was no evidence of bile leakage after EUS‐BD, the possibility of tardive peritonitis due to gradual air leakage from the stent implantation side of the stomach should be considered, and careful follow‐up is needed.https://doi.org/10.1002/deo2.77endoscopic ultrasound‐guided biliary drainageendoscopic ultrasound‐guided hepaticogastrostomygastric outlet obstructionpancreatic cancerperitonitis |
| spellingShingle | Yukitaka Yasuhara Nana Shimamoto Shintaro Tsukinaga Masayuki Kato Kazuki Sumiyama Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report DEN Open endoscopic ultrasound‐guided biliary drainage endoscopic ultrasound‐guided hepaticogastrostomy gastric outlet obstruction pancreatic cancer peritonitis |
| title | Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report |
| title_full | Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report |
| title_fullStr | Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report |
| title_full_unstemmed | Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report |
| title_short | Tardive peritonitis after the endoscopic ultrasound‐guided hepaticogastorostomy: A case report |
| title_sort | tardive peritonitis after the endoscopic ultrasound guided hepaticogastorostomy a case report |
| topic | endoscopic ultrasound‐guided biliary drainage endoscopic ultrasound‐guided hepaticogastrostomy gastric outlet obstruction pancreatic cancer peritonitis |
| url | https://doi.org/10.1002/deo2.77 |
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