Unusual migration of fractured ERCP guidewire: A case report

Abstract Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported...

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Bibliographic Details
Published in:Clinical imaging 2017-05, Vol.43, p.93-96
Main Authors: Pomeranz, Christy B, Wehrli, Natasha E, Tyberg, Amy, Belfi, Lily M
Format: Article
Language:English
Subjects:
Bile
Case reports
Catheterization - adverse effects
Catheterization - methods
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Cholangiopancreatography, Endoscopic Retrograde - methods
Computed tomography
Constriction, Pathologic - complications
Endoscopy
Endoscopy - adverse effects
Endoscopy - methods
Equipment Failure
ERCP complication
Foreign body on MRI
Foreign-Body Migration - diagnostic imaging
Foreign-Body Migration - etiology
Foreign-Body Migration - pathology
Fractures
Fragments
Guidewire fracture
Guidewire migration
Humans
Hydrophobic and Hydrophilic Interactions
Lithotripsy
Lower Extremity
Magnetic resonance imaging
Male
Middle Aged
Migration
Pain
Radiographs
Radiography
Radiology
Retained guidewire
Retroperitoneal foreign body
Retroperitoneal Space
Soft tissues
Tissues
Veins & arteries
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Description
Summary:Abstract Endoscopic retrograde cholangiopancreatography (ERCP) routinely uses hydrophilic guidewires to cannulate ducts and traverse stenoses. Fracture of these guidewires have been reported, however, migration of these fractured fragments is an extremely rare occurrence that has yet to be reported in the literature. We present a case of a fractured ERCP guidewire with extensive migration in the retroperitoneal and lower extremity soft tissues and vasculature with radiologic correlation across multiple modalities—MRI, CT, and radiographs—as well as pathologic correlation. This case illustrates a rare but serious complication of ERCP and demonstrates the imaging findings associated with it.
ISSN:0899-7071
1873-4499
DOI:10.1016/j.clinimag.2017.02.001