Pneumothorax/Pneumomediastinum/Pneumoperitoneum: A Very Rare Complication of ERCP

Abstract

We present a 26-year-old Indian female who presented to the hospital with symptoms of right upper quadrant abdominal pain. Workup was suggestive of cholelithiasis and choledocholithiasis. Patient underwent urgent endoscopic retrograde cholangiopancreatography (ERCP) with sphincterotomy and had successful removal of a stone along with stent placement. Patient developed post-operative back pain and chest pain. Workup revealed retroperitoneal air, pneumoperitoneum, pneumomediastinum and right sided pneumothorax; gastrointestinal series (UGI) gastrograffin study was negative for any leak. Patient underwent chest tube placement which resolved the pneumothorax. Pt improved with non-operative management and did not require any surgical intervention for retroperitoneal duodenal perforation. This is a very rare complication of ERCP described in literature in some case reports and needs to always be considered as missing such complications can have significant morbidity/mortality.




J Med Cases. 2018;9(6):187-189
doi: https://doi.org/10.14740/jmc3070w