Mini Review
Gastric Barotrauma ERCP-Related
A Lauri1, G Rando1 and G Lauri2*
Author Affiliations
1Gastroenterology and Digestive Endoscopy Unit, Italy
2Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele
University, Italy
Received: June 15, 2022 | Published: June 29, 2022
Corresponding author: Gaetano Lauri, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Scientific
Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
DOI: 10.26717/BJSTR.2022.44.007113
A 73-year-old woman was referred to us for endoscopic
biliary drainage of obstructive jaundice due to a pancreatic mass
diagnosed by abdominal computed tomography (CT) scan (Figure
1A). Endoscopic Retrograde CholangioPancreatography (ERCP)
was performed with CO2 insufflation under general anesthesia.
Wire-guided cannulation of the papilla was gently attempted
with the long route because of the distorted anatomy of the
descending duodenum (Figure 1B) and was suddenly stopped
by the anesthesiologist when blood came from the aspiration
tube. Withdrawing the duodenoscope, petechial lesions and deep
longitudinal actively oozing mucosal tears were seen in the lesser
curvature of the stomach from the angulus (Figure 1C) to the
gastroesophageal junction, consistent with gastric barotrauma.
This gastric “cat scratch” is a rare phenomenon that, following
LaPlace’s law, arises when sudden high gaseous pressure leads to
increased wall tensions. It occurs in the lesser gastric curvature
probably because this part of the stomach has a lower capacity for
distension, owing to the lack of mucosal folds and the presence
of the gastrohepatic ligament [1]. At the end of the procedure the
patient immediately experienced epigastric pain and abdominal
distention without any sign of perforation. This is the first case
report showing gastric barotrauma during ERCP.
All authors disclosed no financial relationships.
- Datta S, Adlakha N, Ivanina EA (2016) When the Trauma Comes from Within. American Journal of Gastroenterology 111: 1375.
Mini Review
Gastric Barotrauma ERCP-Related
A Lauri1, G Rando1 and G Lauri2*
Author Affiliations
1Gastroenterology and Digestive Endoscopy Unit, Italy
2Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Scientific Institute, Vita-Salute San Raffaele
University, Italy
Received: June 15, 2022 | Published: June 29, 2022
Corresponding author: Gaetano Lauri, Gastroenterology and Gastrointestinal Endoscopy Unit, IRCCS San Raffaele Scientific
Institute, Vita-Salute San Raffaele University, Via Olgettina 60, 20132, Milan, Italy
DOI: 10.26717/BJSTR.2022.44.007113
A 73-year-old woman was referred to us for endoscopic
biliary drainage of obstructive jaundice due to a pancreatic mass
diagnosed by abdominal computed tomography (CT) scan (Figure
1A). Endoscopic Retrograde CholangioPancreatography (ERCP)
was performed with CO2 insufflation under general anesthesia.
Wire-guided cannulation of the papilla was gently attempted
with the long route because of the distorted anatomy of the
descending duodenum (Figure 1B) and was suddenly stopped
by the anesthesiologist when blood came from the aspiration
tube.