Abstract | HISTORY AND ADMISSION FINDINGS: A 39-year-old obese woman underwent endoscopic retrograde cholangiopancreatography with elective endoscopic biliary sphincterotomy (papillotomy) for symptomatic retained stones in the common bile duct which were extracted completely after added lithotripsy. Three hours later the patient developed profound subcutaneous emphysema of the face, neck and chest wall and shortness of breath, but had no abdominal pain. Physical examination revealed bilaterally diminished breath sounds and a distended and hyper-resonant abdomen, but no evidence of peritonitis. The patient was afebrile and hemodynamically stable. INVESTIGATIONS: THERAPY AND CLINICAL COURSE: Because of the increasing respiratory distress an intercostal drain was placed in the left pneumothorax and broad-spectrum antibiotics were administered. No drain was placed in the right lung. A follow-up CT after three days showed decreasing pneumomediastinum, pneumoperitoneum and pneumoretroperitoneum as well as resolution of the bilateral pneumothorax. The patient made an uneventful recovery and was discharged home seven days after the intervention. CONCLUSION:
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Authors | M Brueck, D Bandorski, K Rauber, E Lotterer |
Journal | Deutsche medizinische Wochenschrift (1946)
(Dtsch Med Wochenschr)
Vol. 135
Issue 17
Pg. 853-6
(Apr 2010)
ISSN: 1439-4413 [Electronic] Germany |
Vernacular Title | Pneumoretroperitoneum und beidseitiger Pneumothorax nach endoskopischer Sphinkterotomie. |
PMID | 20408103
(Publication Type: Case Reports, English Abstract, Journal Article)
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Copyright | Georg Thieme Verlag KG Stuttgart, New York. |
Topics |
- Adult
- Bile Ducts
(surgery)
- Female
- Humans
- Pneumothorax
(diagnosis, etiology, therapy)
- Postoperative Complications
- Retropneumoperitoneum
(diagnosis, etiology, therapy)
- Sphincterotomy, Endoscopic
(adverse effects)
- Subcutaneous Emphysema
(diagnosis, etiology, therapy)
- Treatment Outcome
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