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Korean J Pancreas Biliary Tract > Volume 16(2):2011 > Article
The Korean Journal of Pancreas and Biliary Tract 2011;16(2):169-174.
ERCP 후 발생한 후복막 괴사성 근막염 1예
현종진, 이홍식, 정성우, 구자설, 임형준, 이상우, 최재현, 김창덕, 류호상
고려대학교 의과대학 내과학교실
Retroperitoneal Necrotizing Fasciitis after Endoscopic Retrograde Cholangiopancreatography
Jong Jin Hyun, Hong Sik Lee, Sung Woo Jung, Ja Seol Goo, Hyung Joon Yim, Sang Woo Lee, Jae Hyun Choi, Chang Duck Kim, Ho Sang Ryu
Division of Gastroenterology and Hepatology, Department of Internal Medicine, Korea University College of Medicine
ABSTRACT
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.
Keywords: Retroperitoneal necrotizing fasciitis, Endoscopic retrograde cholangiopancreatography, Endoscopic sphincterotomy
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