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Endoscopic Retrograde Cholangiopancreatography

Cholangiopancreatographies Endoscopic Retrograde


Presentation

  • Pituitary apoplexy is an uncommon neurosurgical emergency that may be the initial presentation of undiagnosed pituitary adenomas.[ncbi.nlm.nih.gov]
  • We present a unique case of crowned dens syndrome (CDS) that developed after endoscopic retrograde cholangiopancreatography (ERCP) in a patient who presented with fever and neck pain.[ncbi.nlm.nih.gov]
  • Some of these complications occur frequently, while others are extremely rare, as in the case presented here. In this case report, we present a woman who suffered an electrical burn in the liver during therapeutic ERCP.[ncbi.nlm.nih.gov]
  • A 76-year-old female patient presented for an endoscopic retrograde cholangiopancreatography (ERCP) for the removal of a biliary stent and lithotripsy.[ncbi.nlm.nih.gov]
  • We considered hyperbaric oxygen therapy for neurological injury but, despite the severe initial presentation, she had a complete clinical recovery with only conservative treatment.[ncbi.nlm.nih.gov]
Hypoxemia
  • The most frequent adverse event was hypoxemia (5.7%), followed by bradycardia (2.4%) and hypotension (1.6%).[ncbi.nlm.nih.gov]
Neck Pain
  • In a patient with fever and neck pain after an ERCP procedure, CDS should be considered in the differential diagnosis.[ncbi.nlm.nih.gov]

Workup

Direct Bilirubin Increased
  • Nevertheless, serum direct bilirubin increased further up to 15 mg/dL. Other potential causes of direct hyperbilirubinemia were ruled out and patient's liver biopsy was compatible with drug-induced liver toxicity.[ncbi.nlm.nih.gov]
Cytopenia
  • Atypical haemolytic uraemic syndrome (aHUS) is a rare but life-threatening complement system-related disorder, characterized by renal failure, non-immune haemolytic anaemia and thrombo-cytopenia.[ncbi.nlm.nih.gov]

Treatment

  • A session of ESWL before ERCP compared with ERCP only resulted in similar outcomes in terms of successful stone removal within the first treatment session (74.2% vs 71.0%, P 0.135), but a higher clearance rate within the second treatment session (84.4%[ncbi.nlm.nih.gov]
  • The presence of common bile duct stones complicates treatment, often requiring a second procedure for stone retrieval.[ncbi.nlm.nih.gov]
  • We discussed treatment options and concluded that eculizumab could be a beneficial alternative to plasma exchanges in the management of such complications.[ncbi.nlm.nih.gov]
  • Percutaneous drainage is an effective treatment.[ncbi.nlm.nih.gov]
  • Endoscopic treatment of biliopancreatic disorders is particularly challenging in patients with altered anatomy.[ncbi.nlm.nih.gov]

Prognosis

  • However, because of this carcinoma's great propensity for early local invasion of adjacent vital structures by neural, perineural, subepithelial, and lymphatic spread, the prognosis of these patients is usually guarded.[jamanetwork.com]

Etiology

  • It was believed to be an air embolism and an urgent transthoracic echocardiography was ordered which confirmed the etiological diagnosis.[ncbi.nlm.nih.gov]
  • INTRODUCTION: Per-oral pancreatoscopy can be used for both evaluation and treatment of pancreatic duct stones during endoscopic retrograde cholangiopancreatography, evaluating and treating pancreatic duct strictures of indeterminate etiology, and visual[ncbi.nlm.nih.gov]
  • While ERCP is effective in palliating obstructive jaundice, standard diagnostic tools in ERCP have a low diagnostic sensitivity and confirm the stricture's etiology in Among patients with indeterminate bile duct strictures, the investigators hypothesize[clinicaltrials.gov]
  • According to the ASGE, indications for ERCP with pancreatic disease are for the assessment and treatment of: Symptomatic pancreatic duct stones Symptomatic strictures accompanying chronic pancreatitis Recurrent acute pancreatitis of unknown etiology Symptomatic[news-medical.net]

Epidemiology

  • Copyright 2017 Association for Professionals in Infection Control and Epidemiology, Inc. Published by Elsevier Inc. All rights reserved. KEYWORDS: Decontamination; Endoscope; Salmonella[ncbi.nlm.nih.gov]
  • His educational background includes engineering, epidemiology, gastroenterology and technical expertise in endoscopy.[books.google.ro]
  • Background: Whole-genome sequencing (WGS) is an emerging and powerful technique by which to perform epidemiological studies in outbreak situations.[ncbi.nlm.nih.gov]
  • The American Gastroenterological Association (AGA) Center for GI Innovation and Technology convened a meeting, "Getting to Zero," with experts in gastroenterology, epidemiology and infectious disease; the endoscope manufacturers Fuji and Pentax; and representatives[gastro.org]
Sex distribution
Age distribution

Pathophysiology

  • Pathophysiology of PEP The pathophysiology of PEP is not well understood. Mechanical, hydrostatic, chemical, enzymatic, allergic, thermal, cytokine, oxidative, and microbiological factors have all been proposed as causes [ 32 , 41 – 46 ].[intechopen.com]

Prevention

  • Conclusions A 25-mg rectal dose of diclofenac might prevent PEP. KEYWORDS: 25-mg dose; ERCP; diclofenac; post-ERCP pancreatitis; prevention[ncbi.nlm.nih.gov]
  • A single dose of indomethacin after ERCP might be effective in preventing PEP in both high-risk and average-risk patients.[ncbi.nlm.nih.gov]
  • The aim of the present study was to evaluate the efficacy of rectal NSAIDs in the prevention of PEP in unselected patients.[ncbi.nlm.nih.gov]
  • Prophylactic antibiotics reduce bacteriaemia and seem to prevent cholangitis and septicaemia in patients undergoing elective ERCP. In the subgroup of patients with uncomplicated ERCP, the effect of antibiotics may be less evident.[ncbi.nlm.nih.gov]
  • In subgroup analysis of patients with a high risk of PEP, diclofenac neither prevented PEP nor made its course milder.[ncbi.nlm.nih.gov]

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