Pneumoperitoneum following percutaneous biliary intervention: not necessarily a cause for alarm.
Percutaneous transhepatic cholangiography (PTC) is a well-established technique for assessing and treating obstructive jaundice. Plastic and self-expanding metal stents can be deployed as an alternative when ERCP is not feasible or hilar strictures require an antegrade approach. Complication rates of percutaneous procedures are low, and are usually related to bile leakage or hemorrhage; pneumoperitoneum following PTC is rare and is usually taken to indicate bowel perforation. We describe two cases of pneumoperitoneum without peritonitis following PTC and stenting, both of which resolved spontaneously with conservative management. The literature is reviewed and possible causes discussed.
Amonkar
Suraj J
SJ
Manchester Radiology Training Scheme, University of Manchester, Manchester, M13 9PL, UK. surajamonkar@hotmail.com
Laasch
Hans-Ulrich
HU
Valle
Juan W
JW
D001661:Biliary Tract Neoplasms / Q000150:complications; D002758:Cholangiography; D003251:Constriction, Pathologic; D003287:Contrast Media; D004380:Duodenal Obstruction / Q000000981:diagnostic imaging / Q000209:etiology / Q000628:therapy*; D006801:Humans; D041781:Jaundice, Obstructive / Q000628:therapy*; D008297:Male; D008875:Middle Aged; D010166:Palliative Care; D011027:Pneumoperitoneum / Q000000981:diagnostic imaging / Q000209:etiology*; D015607:Stents; D014057:Tomography, X-Ray Computed
D003287:Contrast Media