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Pneumoretroperitoneum post ERCP perforation

Case contributed by Dr Hani Salam

Presentation:

Obstructive jaundice

Patient Data:

Gender: Male

ERCP

Modality: Fluoroscopy

Four images from an ERCP. On the second image there is an endoscope with opacification of the pancreatic duct. On the third image, air outlines the retroperitoneal space, compatible with a perforation. On the fourth image, there is increased retroperitoneal air (and air in the central bile ducts).

Cholecystectomy clips.

Modality: X-ray

Extensive retroperitoneal gas on the right, compatible with post ERCP perforation.

Modality: CT

CT appearance of the right retropneumoperitoneum.

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