Atlas of Gastroenterological Endoscopy
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Prepapillary perforation
Prepapillary perforation Diagnostic evaluation after a severe colic attack in obstructive jaandice secondary to gall bladder stones. Before reaching the papilla with the duodenoscope a supra- papillary lesion of the mucosa is viewed. Injection of contrast medium demonstrates a connection to the bile duct. A submucous fistula is depicted. The origin of this fistula was a prepapillary stone perforation from the intramural part of the bile duct to the juxtapaillary region of the duodenum.
  • Katheterspitze = tip of catheter