ABSTRACT Perforation after endoscopic retrograde cholan- giopancreatography (ERCP) is a rare but severe complication. Management of ERCP-associated duodenal perforation remains controversial. Some recommend surgery, while others recommend conservative treatment. We describe the case who developed perforation of the duodenum and gas in the retroperitoneal cavity after ERCP. There was no sign of peritonitis, pancreatitis or sepsis. The patient was treated by conservative therapy without operation, and finally, fully re- covered from perforation.
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Tsuji, A. , Hashimoto, D. , Ozaki, T. , Chikamoto, A. , Beppu, T. and Baba, H. (2012) Perforation of the duodenum during the retrograde cholangiopancreatography treated without surgery. Case Reports in Clinical Medicine, 1, 23-25. doi: 10.4236/crcm.2012.12007.
 Lien, H.H., Huang, C.S., Shi, M.Y., Chen, D.F., Wang, N.Y., Tai, F.C., et al. (2004) Management of bile leakage after laparoscopic cholecystectomy based on etiological classification. Surgery Today, 34, 326-330.
 Binmoeller, K.F., Katon, R.M. and Shneidman, R. (1991) Endoscopic management of postoperative biliary leaks: Review of 77 cases and report of two cases with biloma formation. The American Journal of Gastroenterology, 86, 227-231.
 Christensen, M., Matzen, P., Schulze, S. and Rosenberg, J. (2004) Complications of ERCP: A prospective study. Gastrointestinal Endoscopy, 60, 721-731.
 Enns, R., Eloubeidi, M.A., Mergener, K., Jowell, P.S., Branch, M.S., Pappas, T.M., et al. (2002) ERCP-related perforations: Risk factors and management. Endoscopy, 34, 293-298. doi:10.1055/s-2002-23650
 Pungpapong, S., Kongkam, P., Rerknimitr, R. and Kullavanijaya, P. (2005) Experience on endoscopic retrograde cholangiopancreatography at tertiary referral center in Thailand: risks and complications. Journal of the Medical Association of Thailand, 88, 238-246.
 Kim, J., Lee, S.H., Paik, W.H., Song, B.J., Hwang, J.H., Ryu, J.K., et al. (2012) Clinical outcomes of patients who experienced perforation associated with endoscopic retrograde cholangiopancreatography. Surgical Endoscopy, 26, 3293-3300. doi:10.1007/s00464-012-2343-z
 Booth, F.V., Doerr, R.J., Khalafi, R.S., Luchette, F.A. and Flint, L.M. (1990) Surgical management of complications of endoscopic sphincterotomy with precut papillotomy. The American Journal of Surgery, 159, 132-135.
 Dubecz, A., Ottmann, J., Schweigert, M., Stadlhuber, R.J., Feith, M., Wiessner, V., et al. (20124) Management of ERCP-related small bowel perforations: The pivotal role of physical investigation. Canadian Journal of Surgery, 55, 99-104.
 Kim, B.S., Kim, I.G., Ryu, B.Y., Kim, J.H., Yoo, K.S., Baik, G.H. et al. (2011) Management of endoscopic retrograde cholangiopancreatography-related perforations. Journal of the Korean Surgical Society, 81, 195-204. doi:10.4174/jkss.2011.81.3.195
 Kayhan, B., Akdogan, M. and Sahin, B. (2004) ERCP subsequent to retroperitoneal perforation caused by endoscopic sphincterotomy. Gastrointestinal Endoscopy, 60, 833-835. doi:10.1016/S0016-5107(04)02171-6