Variants of clinical manifestation of retroduodenal perforation at endoscopic papillosphincterotomy

Objective: to study clinical manifestations of retroduodenal perforations in conducting ES and instrumental revision of the bile ducts, the study of predisposing factors, determining the optimal equipment trial cannulation. Material and Methods. On the experience of 41 observations was studied manifested symptoms, anatomical features, technology ES. Results. Retroduodenal perforation manifests progressive subcutaneous emphysema in the first 12 hours after EPST, acute dynamic ileus in the same period, pain with preserved peristalsis and more remote: hepatoduodenal ligament abscess, duodenal fistula of retroperitoneal space and pneumomediastinum. The use of conductors reduces the occurrence of perforation in 40%. Conclusion. It is revealed that retroduodenal perforation may occur in 6 clinical variants predisposing factors are atypical anatomical variants, trial cannulations without the use of conductors.