Which is a major complication of ERCP and its general management?

Which is a major complication of ERCP and its general management?

• A. Pancreatitis, cholangitis, perforation, and bleeding.
• B. Allergic gastritis treated with antacids.
• C. Myocardial infarction managed with observation only.
• D. Aortic dissection managed with vasodilators.

Answer: (A)

ERCP involves instrumenting and manipulating the biliary and pancreatic ducts, so the major complications you watch for are pancreatitis, cholangitis, perforation, and bleeding. Pancreatitis occurs when the pancreatic duct is irritated by the scope or contrast; it’s managed with supportive care—aggressive IV fluids, pain control, and typically no oral intake until symptoms improve. Cholangitis is an infection of the bile ducts that can follow obstruction or instrumentation; treat it with broad-spectrum antibiotics and urgent biliary drainage to relieve the obstruction, usually achieved with another ERCP or drainage procedure. Perforation is a risk from scope or device use; small, stable perforations may be treated nonoperatively with NPO status and antibiotics, but larger or unstable injuries often require surgical intervention. Bleeding commonly results from sphincterotomy; it is usually controlled endoscopically using techniques such as epinephrine injection, clips, or cautery, with transfusion if needed and surgical or radiologic control if bleeding continues. These complications are distinct from issues not related to ERCP, such as allergic gastritis or certain cardiovascular problems, which aren’t typical ERCP complications.

ERCP involves instrumenting and manipulating the biliary and pancreatic ducts, so the major complications you watch for are pancreatitis, cholangitis, perforation, and bleeding. Pancreatitis occurs when the pancreatic duct is irritated by the scope or contrast; it’s managed with supportive care—aggressive IV fluids, pain control, and typically no oral intake until symptoms improve. Cholangitis is an infection of the bile ducts that can follow obstruction or instrumentation; treat it with broad-spectrum antibiotics and urgent biliary drainage to relieve the obstruction, usually achieved with another ERCP or drainage procedure. Perforation is a risk from scope or device use; small, stable perforations may be treated nonoperatively with NPO status and antibiotics, but larger or unstable injuries often require surgical intervention. Bleeding commonly results from sphincterotomy; it is usually controlled endoscopically using techniques such as epinephrine injection, clips, or cautery, with transfusion if needed and surgical or radiologic control if bleeding continues.

These complications are distinct from issues not related to ERCP, such as allergic gastritis or certain cardiovascular problems, which aren’t typical ERCP complications.