RETROPERITONEAL ABSCESS AFTER ENDOSCOPIC SPHINCTEROTOMY - AN UNUSUAL AND SEVERE COMPLICATION

We report the case of a 55 year old female patient, previously cholecy stectomized, who was admitted to the Hospital because of recurrent bil iary abdominal pain, cholestasis and common bile duct enlargement by u ltrasonography. 48 hours after an endoscopic sphincterotomy the patien t developed abdominal pain and fever. CT scan demonstrated air and an infected liquid collection in the retroperitoneum. Although a percutan eous drainage was attempted, the persistence of the symptoms and the l ow drainage outflow of the infected material made surgical treatment n ecessary. Duodenal perforation in endoscopic sphincterotomy is an unus ual but severe complication that leads to a high mortality rate if sur gical treatment is not applied promptly. Sometimes retropneumoperitone um can be satisfactory solved just with a conservative medical therapy , but if there is a suspected or confirmed infected collection surgica l treatment must be applied promptly.