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KMID : 0985520110160020169
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Korean Journal of Pancreas and Biliary Tract
2011 Volume.16 No. 2 p.169 ~ p.174
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Retroperitoneal Necrotizing Fasciitis after Endoscopic Retrograde Cholangiopancreatography
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Hyun Jong-Jin
Lee Hong-Sik
Jung Sung-Woo
Koo Ja-Seol
Yim Hyung-Joon
Lee Sang-Woo
Choi Jai-Hyun
Kim Chang-Duck
Ryu Ho-Sang
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Abstract
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Performing endoscopic sphincterotomy (EST) is essential during many diagnostic and therapeutic endoscopic retrograde cholangiopancreatography (ERCP) but it carries a complication rate of about 10%, among which EST related perforation is one of the most worrisome complication. A 72-year-old female with hypertension and diabetes presented with right upper quadrant discomfort and fever and was diagnosed with cholecystitis. Before surgery, she underwent ERCP to evaluate the cause of air-biliarygram and collapsed gallbladder seen on abdominal sonogram and abdominal CT scan. After undergoing ERCP without apparent complication, the patient developed right lower quadrant pain the next day, and follow-up abdominal CT scan revealed free air with probable food material in the extraperitoneal space that extended from the pancreaticoduodenal groove to right abdomen. She was diagnosed with retroperitoneal necrotizing fasciitis and underwent emergency operation but died few days later due to septic shock. Herein, we report a case of retroperitoneal necrotizing fasciitis that developed after ERCP.
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KEYWORD
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Retroperitoneal necrotizing fasciitis, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy
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