PMC5449572_01
Endoscopic appearance of ampulla and surrounding duodenal mucosa. (A) Biliary sphincterotome entering the CBD. (B) Withdrawal of balloon from ampulla without evidence of hemorrhage or hematoma.
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F1
The ampulla was carefully examined to confirm adequacy of sphincterotomy and to ensure hemostasis (Figure 1).
View at laparotomy of ruptured duodenal hematoma with surrounding hemoperitoneum and retracted serosal margin.
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F2
The pressure from the hematoma tore away the serosa, narrowed the duodenal lumen, and ruptured into the abdomen (Figure 2).
T-tube cholangiogram obtained 70 days following surgery demonstrating absence of biliary stone or stricture and prompt filling of duodenum without luminal compression.
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F3
At her 2-month follow-up, a cholangiogram demonstrated a normal biliary tree, and the T-tube was removed (Figure 3).