Digestive_Cholangiopancreatography_slide18_2017.pdf -...

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1 Documentation Dissection PROCEDURE: Endoscopic retrograde cholangiopancreatography with biopsy and stent placement |1| . PREOPERATIVE DIAGNOSES: 1. Jaundice |2| . 2. Abnormal CT scan |2| . POSTOPERATIVE DIAGNOSES: 1. Bile duct stricture treated with deployment of Wall stent |3| . 2. Mass involving the duodenum |3| . BODY OF NOTE: The patient is a 43-year-old has developed jaundice and a CT scan showed dilated biliary tract. For this reason, endoscopic retrograde cholangiopancreatography |4| is undertaken. The risks of the procedure including perforation, peritonitis, pancreatitis, bleeding, and death were discussed in detail with the patient and his wife. He understood and agreed. He had no physical or historical contraindications to conscious sedation. He was sedated with 10 mg of Versed, 350 mg of Sublimaze given intravenously in incremental fashion |5| . Glucagon 1 mg was given to decrease email bowel motility. A standard videoduodenoscope was passed without difficulty through the upper esophageal sphincter, advanced into the stomach where there was a large amount of retained gastric contents. In the antrum, the pylorus was identified |6| . I was able to pass the duodenoscope into the duodenum and duodenum bulb and second portion of duodenum. There was a friable mass involving one wall of the duodenum and biopsies
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  • Spring '19
  • NONE
  • Digestive System, duodenum, Endoscopic retrograde cholangiopancreatography

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Christopher Reinemann
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