Bowel perforation at ERCP

Discussion:

Perforation of the duodenum is a recognized complication of endoscopic retrograde cholangiopancreatography (ERCP). This case illustrates that careful review of the ERCP images may allow earlier identification of complications such as pneumoperitoneum or pneumoretroperitoneum. Inverting the image enables the bubbly lucency of free air in the retroperitoneum to be more easily discerned.

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