“…Additionally, in selected cases gastroduodenal opacification by means of peroral ingestion of diluted enteral CM may be beneficial to confirm or exclude leakage indicating DP (Fig. 1 ) [ 6 , 13 – 15 ]. Fig.…”
Section: Early Post-ercp Imaging: Indications Techniques Usual Findmentioning
confidence: 99%
“…Shortly after ERCP retained CM is commonly seen in the biliary tree and gallbladder, often with a characteristic stratified appearance (Fig. 2 ) [ 13 , 15 ]. Fig.…”
Section: Early Post-ercp Imaging: Indications Techniques Usual Findmentioning
confidence: 99%
“…4 and 5 ). Borrowing from experience with gallstone AP, early contrast-enhanced CT obtained within 2–3 days from the onset of symptoms may underestimate the severity of PEAP including confident exclusion of necrosis so that repeated scanning may be required during post-ERCP hospitalisation [ 13 , 15 , 16 , 22 , 23 ]. Fig.…”
Section: Acute Pancreatitismentioning
confidence: 99%
“…PNPFCs may become progressively more organised and encapsulated later and are termed walled-off pancreatic necrosis after 4 weeks of symptom onset (Fig. 7 ) [ 13 , 15 , 16 , 22 , 23 ]. Fig.…”
Section: Acute Pancreatitismentioning
confidence: 99%
“…Based upon 8 years of personal experience at a university-based general hospital where approximately 230 ERCPs are performed each year, this pictorial essay reviews and illustrates the normal post-procedural appearances observed shortly after ERCP, and the imaging findings associated with common and unusual complications, aiming to provide radiologists with an increased familiarity with interpretation of early post-procedural studies for an optimal triage of complications. Most of the emphasis is placed on the pivotal role of multidetector CT, which represents, according to the WSES guidelines for management of intra-abdominal infections, the preferred and most effective modality to comprehensively investigate the abdomen and pelvis to search for possible iatrogenic complications [ 6 , 12 – 15 ].…”
Endoscopic retrograde cholangiopancreatography (ERCP) is currently a primarily therapeutic procedure that is extensively employed to treat several biliopancreatic disorders. Although widely considered a safe procedure, ERCP is associated with a non-negligible morbidity and occasional mortality. Due to the number and complexity of operative ERCPs performed, radiologists are increasingly faced with urgent requests for investigation of suspected post-procedural complications, which often have similar clinical and laboratory manifestations. This pictorial essay reviews the usual post-procedural CT findings, the clinical features and imaging appearances of common and unusual post-ERCP occurrences including interstitial oedematous and necrotising acute pancreatitis, haemorrhages, retroperitoneal and intraperitoneal duodenal perforations, infections and stent-related complications. Emphasis is placed on the pivotal role of multidetector CT, which is warranted after complex or prolonged ERCP procedures as it represents the most effective modality to detect and grade ERCP-related complications and to monitor nonsurgically treated patients. Timely diagnosis and optimal management require a combination of clinical and laboratory data with imaging appearances; therefore, this article aims to provide an increased familiarity with interpretation of early post-ERCP studies, particularly to triage those occurrences that require interventional or surgical treatment. In selected patients MRI allows imaging pancreatitis and abnormal collections without the use of ionising radiation.Teaching Points• Endoscopic retrograde cholangiopancreatography (ERCP) allows treating many biliopancreatic disorders.• Due to the number and complexity of procedures, post-ERCP complications are increasingly encountered.• Main complications include acute pancreatitis, haemorrhages, duodenal perforation and infections.• Diagnosis and management of complications rely on combined clinical, laboratory and imaging data.• Multidetector CT is most effective to diagnose, categorise and monitor post-ERCP complications.
“…Additionally, in selected cases gastroduodenal opacification by means of peroral ingestion of diluted enteral CM may be beneficial to confirm or exclude leakage indicating DP (Fig. 1 ) [ 6 , 13 – 15 ]. Fig.…”
Section: Early Post-ercp Imaging: Indications Techniques Usual Findmentioning
confidence: 99%
“…Shortly after ERCP retained CM is commonly seen in the biliary tree and gallbladder, often with a characteristic stratified appearance (Fig. 2 ) [ 13 , 15 ]. Fig.…”
Section: Early Post-ercp Imaging: Indications Techniques Usual Findmentioning
confidence: 99%
“…4 and 5 ). Borrowing from experience with gallstone AP, early contrast-enhanced CT obtained within 2–3 days from the onset of symptoms may underestimate the severity of PEAP including confident exclusion of necrosis so that repeated scanning may be required during post-ERCP hospitalisation [ 13 , 15 , 16 , 22 , 23 ]. Fig.…”
Section: Acute Pancreatitismentioning
confidence: 99%
“…PNPFCs may become progressively more organised and encapsulated later and are termed walled-off pancreatic necrosis after 4 weeks of symptom onset (Fig. 7 ) [ 13 , 15 , 16 , 22 , 23 ]. Fig.…”
Section: Acute Pancreatitismentioning
confidence: 99%
“…Based upon 8 years of personal experience at a university-based general hospital where approximately 230 ERCPs are performed each year, this pictorial essay reviews and illustrates the normal post-procedural appearances observed shortly after ERCP, and the imaging findings associated with common and unusual complications, aiming to provide radiologists with an increased familiarity with interpretation of early post-procedural studies for an optimal triage of complications. Most of the emphasis is placed on the pivotal role of multidetector CT, which represents, according to the WSES guidelines for management of intra-abdominal infections, the preferred and most effective modality to comprehensively investigate the abdomen and pelvis to search for possible iatrogenic complications [ 6 , 12 – 15 ].…”
Endoscopic retrograde cholangiopancreatography (ERCP) is currently a primarily therapeutic procedure that is extensively employed to treat several biliopancreatic disorders. Although widely considered a safe procedure, ERCP is associated with a non-negligible morbidity and occasional mortality. Due to the number and complexity of operative ERCPs performed, radiologists are increasingly faced with urgent requests for investigation of suspected post-procedural complications, which often have similar clinical and laboratory manifestations. This pictorial essay reviews the usual post-procedural CT findings, the clinical features and imaging appearances of common and unusual post-ERCP occurrences including interstitial oedematous and necrotising acute pancreatitis, haemorrhages, retroperitoneal and intraperitoneal duodenal perforations, infections and stent-related complications. Emphasis is placed on the pivotal role of multidetector CT, which is warranted after complex or prolonged ERCP procedures as it represents the most effective modality to detect and grade ERCP-related complications and to monitor nonsurgically treated patients. Timely diagnosis and optimal management require a combination of clinical and laboratory data with imaging appearances; therefore, this article aims to provide an increased familiarity with interpretation of early post-ERCP studies, particularly to triage those occurrences that require interventional or surgical treatment. In selected patients MRI allows imaging pancreatitis and abnormal collections without the use of ionising radiation.Teaching Points• Endoscopic retrograde cholangiopancreatography (ERCP) allows treating many biliopancreatic disorders.• Due to the number and complexity of procedures, post-ERCP complications are increasingly encountered.• Main complications include acute pancreatitis, haemorrhages, duodenal perforation and infections.• Diagnosis and management of complications rely on combined clinical, laboratory and imaging data.• Multidetector CT is most effective to diagnose, categorise and monitor post-ERCP complications.
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