Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology

In the last thirty years, the widespread use of endoscopic retrograde cholangiopancreatography (ERCP) has radically changed the management of patients with diseases of the extrahepatic biliary tract and pancreas. Pneumothorax is a rare complication of ERCP. We report two cases of pneumothorax follow...

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Main Authors: Kyriakos Neofytou, Athanasios Petrou, Constantinos Savva, Christos Petrides, Charalampos Andreou, Evangelos Felekouras, Sakis Loizou
Format: Article
Language:English
Published: Wiley 2013-01-01
Series:Case Reports in Medicine
Online Access:http://dx.doi.org/10.1155/2013/206564
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author Kyriakos Neofytou
Athanasios Petrou
Constantinos Savva
Christos Petrides
Charalampos Andreou
Evangelos Felekouras
Sakis Loizou
author_facet Kyriakos Neofytou
Athanasios Petrou
Constantinos Savva
Christos Petrides
Charalampos Andreou
Evangelos Felekouras
Sakis Loizou
author_sort Kyriakos Neofytou
collection DOAJ
description In the last thirty years, the widespread use of endoscopic retrograde cholangiopancreatography (ERCP) has radically changed the management of patients with diseases of the extrahepatic biliary tract and pancreas. Pneumothorax is a rare complication of ERCP. We report two cases of pneumothorax following elective ERCP for ductal stone clearance. The first patient was a 45-year-old female, who developed respiratory distress, abdominal pain, and profoundly abdominal distention immediately after the procedure. Imaging studies revealed the presence of a right-side pneumothorax, pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum. The second patient was a 94-year-old female, who developed tension pneumothorax with clinical signs of shock during the procedure. Imaging studies revealed the presence of a right-side pneumothorax without free air in the mediastinum and retroperitoneal space. The imaging findings suggest that the occurrence of this rare complication in our patients was caused by entirely different pathophysiological mechanisms. Both patients were successfully treated with chest tube insertion, and no further intervention was required. Clinicians should be aware of this serious complication because delayed diagnosis may involve significant morbidity and mortality risks.
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spelling doaj-art-3cdcc16e07134ccab79085f7b3d9c8c52025-08-20T03:55:39ZengWileyCase Reports in Medicine1687-96271687-96352013-01-01201310.1155/2013/206564206564Pneumothorax following ERCP: Report of Two Cases with Different PathophysiologyKyriakos Neofytou0Athanasios Petrou1Constantinos Savva2Christos Petrides3Charalampos Andreou4Evangelos Felekouras5Sakis Loizou6Department of Surgery, Nicosia Government Hospital, Palaios Dromos Lefkosias-Lemesou, No. 215, Strovolos, 2029 Nicosia, CyprusDepartment of Surgery, Nicosia Government Hospital, Palaios Dromos Lefkosias-Lemesou, No. 215, Strovolos, 2029 Nicosia, CyprusDepartment of Surgery, Aretaeio Private Hospital, Andrea Avraamides Street, Dasoupoli, 2014 Nicosia, CyprusDepartment of Surgery, Nicosia Government Hospital, Palaios Dromos Lefkosias-Lemesou, No. 215, Strovolos, 2029 Nicosia, CyprusDepartment of Surgery, Nicosia Government Hospital, Palaios Dromos Lefkosias-Lemesou, No. 215, Strovolos, 2029 Nicosia, CyprusFirst Department of Surgery, Laiko General Hospital, University of Athens Medical School, 115 27 Athens, GreeceDepartment of Surgery, Nicosia Government Hospital, Palaios Dromos Lefkosias-Lemesou, No. 215, Strovolos, 2029 Nicosia, CyprusIn the last thirty years, the widespread use of endoscopic retrograde cholangiopancreatography (ERCP) has radically changed the management of patients with diseases of the extrahepatic biliary tract and pancreas. Pneumothorax is a rare complication of ERCP. We report two cases of pneumothorax following elective ERCP for ductal stone clearance. The first patient was a 45-year-old female, who developed respiratory distress, abdominal pain, and profoundly abdominal distention immediately after the procedure. Imaging studies revealed the presence of a right-side pneumothorax, pneumomediastinum, pneumoperitoneum, and pneumoretroperitoneum. The second patient was a 94-year-old female, who developed tension pneumothorax with clinical signs of shock during the procedure. Imaging studies revealed the presence of a right-side pneumothorax without free air in the mediastinum and retroperitoneal space. The imaging findings suggest that the occurrence of this rare complication in our patients was caused by entirely different pathophysiological mechanisms. Both patients were successfully treated with chest tube insertion, and no further intervention was required. Clinicians should be aware of this serious complication because delayed diagnosis may involve significant morbidity and mortality risks.http://dx.doi.org/10.1155/2013/206564
spellingShingle Kyriakos Neofytou
Athanasios Petrou
Constantinos Savva
Christos Petrides
Charalampos Andreou
Evangelos Felekouras
Sakis Loizou
Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
Case Reports in Medicine
title Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
title_full Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
title_fullStr Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
title_full_unstemmed Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
title_short Pneumothorax following ERCP: Report of Two Cases with Different Pathophysiology
title_sort pneumothorax following ercp report of two cases with different pathophysiology
url http://dx.doi.org/10.1155/2013/206564
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