Skip to main content

Advertisement

Log in

Pneumoperitoneum Following Percutaneous Biliary Intervention: Not Necessarily a Cause for Alarm

  • Case Report
  • Published:
CardioVascular and Interventional Radiology Aims and scope Submit manuscript

Abstract

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.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Coons H (1992) Metallic stents for the treatment of biliary obstruction: a report of 100 cases. CardioVasc Interv Radiol 15:367–374

    Article  CAS  Google Scholar 

  2. Lee BMJ, Dawson SL, Mueller PR, Saini S, Hahn PF, Goldberg MA, Lu DS, Mayo-Smith WW (1993) Percutaneous management of hilar biliary malignancies with metallic endoprostheses: results, technical problems, and causes of failure. Radiographics 13:1249–1263

    PubMed  CAS  Google Scholar 

  3. Lee KH, Lee DY, Kim KW (2004) Biliary intervention for cholangiocarcinoma. Abdom Imaging 29:581–589

    Article  PubMed  Google Scholar 

  4. Hii MW, Gibson RN (2004) Role of radiology in the treatment of malignant hilar biliary strictures 1: review of the literature. Australas Radiol 48:3–13

    Article  PubMed  Google Scholar 

  5. Born P, Rosch T, Bruhl K, Sandschin W, Allescher HD, Frimberger E, Classen M (1999) Long-term results of endoscopic and percutaneous transhepatic treatment of benign biliary strictures. Endoscopy 31:725–731

    Article  PubMed  CAS  Google Scholar 

  6. Laasch HU, Martin DF (2002) Management of benign biliary strictures. CardioVasc Interv Radiol 25:457–466

    Article  Google Scholar 

  7. Ferrucci JT Jr, Mueller PR, Harbin WP (1980) Percutaneous transhepatic biliary drainage: technique, results, and applications. Radiology 135:1–13

    PubMed  Google Scholar 

  8. Winick AB, Waybill PN, Venbrux AC (2001) Complications of percutaneous transhepatic biliary interventions. Tech Vasc Interv Radiol 4:200–206

    Article  PubMed  CAS  Google Scholar 

  9. Lyon SM, Terhaar O, Given MF, O’Dwyer HM, McGrath FP, Lee MJ (2006) Percutaneous embolization of transhepatic tracks for biliary intervention. CardioVasc Interv Radiol 29:1011–1014

    Article  Google Scholar 

  10. Burke DR, Lewis CA, Cardella JF, Citron SJ, Drooz AT, Haskal ZJ, Husted JW, McCowan TC, Van Moore A, Oglevie SB, Sacks D, Spies JB, Towbin RB, Bakal CW (2003) Quality improvement guidelines for percutaneous transhepatic cholangiography and biliary drainage. J Vasc Interv Radiol 14:S243–S246

    PubMed  Google Scholar 

  11. Gendler R, Shapiro RS, Mitty HA, Sterling KM (1993) CT findings after percutaneous biliary procedures. Radiology 187:373–376

    PubMed  CAS  Google Scholar 

  12. Kuhlman JE, Fishman EK, Milligan FD, Siegelman SS (1989) Complications of endoscopic retrograde sphincterotomy: computed tomographic evaluation. Gastrointest Radiol 14:127–132

    Article  PubMed  CAS  Google Scholar 

  13. Bar-Meir S, Lang A, Shemesh E, Nass S, Dreznick Z (1993) Pneumoperitoneum after insertion of endoscopic biliary stent for post-cholecystectomy biliary leak. Gastrointest Endosc 39:818–820

    Article  PubMed  CAS  Google Scholar 

  14. Lee JH, Lee DH, Yu JS, Lee SJ, Kwon WC, Kim KW (2000) Pneumoperitoneum caused by transhepatic air leak after metallic biliary stent placement. Cardiovasc Intervent Radiol 23:482–484

    Article  PubMed  CAS  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Suraj J. Amonkar.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Amonkar, S.J., Laasch, HU. & Valle, J.W. Pneumoperitoneum Following Percutaneous Biliary Intervention: Not Necessarily a Cause for Alarm. Cardiovasc Intervent Radiol 31, 439–443 (2008). https://doi.org/10.1007/s00270-007-9252-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00270-007-9252-x

Keywords

Navigation