Standard fluoroscopy during ERCP before and after sphincterotomy.
Comparing the radiographs taken just before the sphincterotomy and after shows the sudden presence of free intra-abdominal air, which is not consistent with an intraperitoneal distribution; instead, the air is restricted to the space around the right adrenal gland. Although the amount of free air seems limited, the patient developed progressive pneumoretroperitoneum and a CT was performed.