Stapfer et al classified perforations in the duodenum associated with endoscopic retrograde cholangiopancreatography (ERCP).
Lesion
Type
in the lateral duodenal wall (remote from the papilla)
I
injury about the papilla (peri-Vaterian)
II
injury to duct secondary to passage of wire or basket
III
retroperitoneal air without obvious perforation
IV
Management
immediate surgical repair
surgery if indications present (see below)
surgery if indications present
observation
Indications for surgery in Type II or III perforations:
(1) retained stones
(2) retrieve retained hardware
(3) large free air or fluid in retroperitoneum
To read more or access our algorithms and calculators, please log in or register.
Specialty: Gastroenterology
