Abstract
Background and Aims. Few cases of endoscopic retrograde cholangiopancreatography- (ERCP-) related contrast media (CM) adverse reactions have been reported in the current literature. There is a lack of standardisation in practice regarding premedication prophylaxis for at-risk patients undergoing ERCP and there are few data to guide the practitioners. Our goal is to evaluate the risk of CM adverse reaction in a group of patients with a past history of allergic-like reaction to iodine product undergoing ERCP. Methods. A retrospective chart review study was performed of patients who underwent ERCP at our single centre from January 2010 to December 2015. Results. 2295 ERCPs were performed among 1766 patients. No anaphylactoid or severe adverse reaction occurred. One (0.04%) ERCP-related CM benign reaction was reported in a patient known for penicillin allergy. Among 127 ERCPs performed on patients with a prior adverse reaction to iodine, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred. Conclusions. To our knowledge, we report the largest cohort of iodine allergic patients undergoing ERCP ever published. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction.
Highlights
A few cases of endoscopic retrograde cholangiopancreatography- (ERCP-)related contrast media (CM) adverse reactions have been reported in large cohort series [1]
As expected our study suggests that ERCP-related CM adverse reaction is very rare even among patients deemed to be at high risk
We found no severe adverse reaction after 2295 ERCPs performed including 127 ERCPs in patients with prior reaction to iodine product and 828 ERCPs in patients with any allergic diathesis
Summary
A few cases of ERCP-related CM adverse reactions have been reported in large cohort series [1]. The strongest risk factor identified is a prior allergic-like reaction to CM justifying a premedication prophylaxis before IV CM injection and raising the question: Should we use a prophylaxis for ERCP in patients known for a prior CM reaction?. Among 127 ERCPs performed on patients with a prior adverse reaction to iodine, 121 procedures were done without and 6 with a premedication prophylaxis. In both groups, no ERCP-related CM reaction occurred. We report the largest cohort of iodine allergic patients undergoing ERCP ever published. These results suggest that ERCP-related CM adverse reactions are very rare even among patients at risk for CM reaction
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