ERCP Malpractice Note
Side effects after an ERCP can range from mild to life-threatening. Severe ERCP side effects include pancreatitis, organ perforation, infection, hemorrhage, and death. If you have questions about problems after an ERCP, call 888.726.6735
Endoscopic retrograde cholangiopancreatography (ERCP) can diagnose and treat abnormalities that affect a patient’s bile or pancreatic ducts, such as restrictions or blockages. Due to the risk of serious complications, it is recommended that ERCP is only performed when treatment may be administered during the initial diagnostic procedure.
Pancreatitis Bleeding from ERCP
One of the severe complications of the procedure is pancreatitis after ERCP. Patients who develop pancreatitis after ERCP may also suffer pancreatitis bleeding. Pancreatitis bleeding is associated with high mortality rates. Pancreatitis bleeding is a medical emergency that requires hospitalization and close care from qualified medical professionals.
Blood Vessel Erosion
Blood vessel erosion and rupture are among the primary causes of pancreatitis bleeding. As a result of pancreatitis, death of the surrounding tissue often occurs. This can lead to the formation of abscesses, pseudocysts, and pseudoaneurysms which contribute to pancreatitis bleeding.
These growths, along with severe inflammation of the pancreas, can erode major and minor blood vessels in the areas surrounding the pancreas. Additionally, rupture of these growths may also lead to life-threatening pancreatitis bleeding.
Blood Vessel Rupture
When blood vessels reach a certain point of erosion, they may rupture and cause severe pancreatitis bleeding. This pancreatitis bleeding is typically present in the gastrointestinal tract and abdominal cavity near the pancreas and surrounding organs. This pancreatitis bleeding occurrence is rare, yet carries a significant mortality rate of roughly 30 to 40 percent.
The spleen, splenic artery, and other abdominal blood vessels are commonly affected. Also commonly affected is the portal vein. The portal vein is a major blood vessel connecting blood flow from the spleen and gastrointestinal tract to the liver.
Pancreatitis after ERCP can cause the formation and rupture of pseudocysts. Pseudocysts are growths that resemble cysts. They typically contain fluid that is comprised of blood, pancreatic enzymes, and dead cell tissue. In Greek, the name can be translated to “false cyst.” This is because a true cyst is lined with a certain type of tissue called epithelium, while psueudocysts are not.
Formation and rupture of pseudoaneurysms can also lead to lethal pancreatitis bleeding. A pseudoaneurysm is a collection of blood outside the blood vessels due to a leaking artery. Pseudoaneurysms have poorer wall support than true aneurysms, and are thus more likely to rupture.
Treating Pancreatitis Bleeding
Depending on the severity of the pancreatitis bleeding, the patient may require surgery. It is generally recommended to treat growths such as pseudocysts and pseudoaneurysms before they rupture. This preventative approach may eliminate the escalation to pancreatitis bleeding.
Treatment for pancreatitis bleeding may include embolization. Embolization involves use of a blood clot, gas bubble, or globule of fat to block a bleeding blood vessel. Pancreatitis bleeding treatment may also include placement of a covered stent. Thrombin may be injected near the bleeding site to clot the blood. In severe cases, open surgery may be required to repair the damaged blood vessels or remove a growth.
Dimitroulis, Dimitrios, et al. “Surgical control of life-threatening post-ERCP bleeding with a gelatin matrix-thrombin hemostatic agent.” International Journey of Surgery Case Reports. 3.9 (2012): 471-473. Web. 28 Jun. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3397303/>.
Flati, Giancarlo, et al. “Potentially fatal bleeding in acute pancreatitis: pathophysiology, prevention, and treatment..” Pancreas. 26.1 (2003): 8-14. Web. 28 Jun. 2013. <http://www.ncbi.nlm.nih.gov/pubmed/12499910>.
Hsu, Jun-Te, et al. “Management and outcome of bleeding pseudoaneurysm associated with chronic pancreatitis.” BMC Gastroenterology. 6.3 (2006): n. page. Web. 28 Jun. 2013. <http://www.biomedcentral.com/1471-230X/6/3>.
“Pancreatitis.” University of Maryland Medical Center. University of Maryland. Web. 28 Jun 2013. <http://umm.edu/health/medical/altmed/condition/pancreatitis>.
Parikh, Mehul, et al. “Splenic Artery Pseudoaneurysm Complicating Pancreatitis.” Journal of General Internal Medicine. 26.3 (2011): 343-344. Web. 28 Jun. 2013. <http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3043193/>.