title: Unusual migration of fractured ERCP guidewire: A case report.
abstract: Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported in the literature. We present a case of a fractured ERCP guidewire with extensive migration in the retroperitoneal and lower extremity soft tissues and vasculature with radiologic correlation across multiple modalities-MRI, CT, and radiographs-as well as pathologic correlation. This case illustrates a rare but serious complication of ERCP and demonstrates the imaging findings associated with it.
authors.affiliation: New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065-4870, Department of Radiology, United States. Electronic address: chp9024@med.cornell.edu.
authors.forename: Christy B
authors.initials: CB
authors.lastname: Pomeranz
authors.affiliation: New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065-4870, Department of Radiology, United States.
authors.forename: Natasha E
authors.initials: NE
authors.lastname: Wehrli
authors.affiliation: New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065-4870, Department of Radiology, United States.
authors.forename: Amy
authors.initials: A
authors.lastname: Tyberg
authors.affiliation: New York Presbyterian Hospital, Weill Cornell Medical Center, 525 East 68th Street, Box 141, New York, NY 10065-4870, Department of Radiology, United States.
authors.forename: Lily M
authors.initials: LM
authors.lastname: Belfi
mesh_terms: D002404:Catheterization / Q000009:adverse effects* / Q000379:methods; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects* / Q000379:methods; D003251:Constriction, Pathologic / Q000150:complications; D004724:Endoscopy / Q000009:adverse effects / Q000379:methods; D004868:Equipment Failure; D005548:Foreign-Body Migration / Q000000981:diagnostic imaging / Q000209:etiology* / Q000473:pathology; D006801:Humans; D057927:Hydrophobic and Hydrophilic Interactions; D035002:Lower Extremity; D008297:Male; D008875:Middle Aged; D011871:Radiology; D012187:Retroperitoneal Space
keywords: ERCP complication; Foreign body on MRI; Guidewire fracture; Guidewire migration; Retained guidewire; Retroperitoneal foreign body