ArticleCureus2025
Life-Threatening Duodenal Perforation Following Endoscopic Retrograde Cholangiopancreatography in an Elderly Patient: A Case Report.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
1 citing paper in PubMed.
- Air Everywhere: A Rare Post-ERCP Syndrome of Acute Pancreatitis, Pneumothorax, and Multicompartment Air Leak without Perforation.Clinical medicine insights. Case reports · 2026Article
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Authors and funding
5 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable diagnostic and therapeutic procedure for pancreaticobiliary disorders, but may rarely result in severe complications such as duodenal perforation. A 77-year-old man with hypertension, diabetes, dyslipidemia, and benign prostatic hyperplasia presented with painless obstructive jaundice for a duration of four weeks. Laboratory tests showed a cholestatic pattern and elevated carbohydrate antigen 19-9. Magnetic resonance cholangiopancreatography (MRCP) demonstrated marked dilation of the common bile duct with abrupt distal tapering, mild pancreatic duct dilation, and a periampullary diverticulum, suggesting a periampullary neoplastic lesion or fibrotic stenosis. An ERCP was performed for diagnostic clarification and potential therapeutic decompression. Difficult cannulation required a precut sphincterotomy, after which a duodenal perforation was suspected. Post-procedure, the patient developed extensive subcutaneous, retroperitoneal, and mediastinal emphysema, pneumopericardium, and bilateral pneumothoraces. A CT confirmed free intraperitoneal air and contrast extravasation in the retroperitoneal space anterior to the left renal fascia, consistent with a perforation of the third portion of the duodenum. Emergency laparotomy identified and repaired the defect with a Graham patch. Despite intensive care with broad-spectrum antimicrobials and vasopressors, the patient developed septic shock and multi-organ failure and died nine days later. This case underscores the catastrophic potential of ERCP-related duodenal perforation and the importance of early CT diagnosis and individualized intervention in high-risk patients.
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