Pneumoretroperitoneum - post ERCP perforation

Case contributed by Dr Hani Makky Al Salam

Presentation

Obstructive jaundice.

Patient Data

Gender: Male

ERCP

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 pneumobilia.

Cholecystectomy clips.

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

CT appearance of the right pneumoretroperitoneum.

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