{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T23:17:39Z","timestamp":1792797459525,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T00:00:00Z","timestamp":1718841600000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,6,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Endoscopic retrograde cholangiopancreatography (ERCP) is invasive for pancreaticobiliary diseases. Perforation is a rare but severe complication among its associated risks. A 45-year-old female with biliary colic and multiple gallbladder calculi was diagnosed with choledocholithiasis based on imaging showing CBD dilation and gallstones. ERCP was planned for stone removal. Sphincterotomy was performed, but stone retrieval attempts failed, leading to severe pneumo-peritoneum and respiratory compromise. Immediate CBD stenting was done, avoiding surgical intervention. The patient recovered uneventfully, later undergoing laparoscopic cholecystectomy with CBD exploration and stone removal. ERCP-related perforations, rare but severe, involve retroperitoneal air collection. Clinical signs include abdominal discomfort, and imaging confirms diagnosis. Management varies by type, with some requiring surgical repair. Conservative management sufficed in this case, with successful patient recovery. ERCP-related complications like pneumo-peritoneum require prompt diagnosis and conservative management if no perforation is evident.<\/jats:p>","DOI":"10.1093\/jscr\/rjae415","type":"journal-article","created":{"date-parts":[[2024,6,20]],"date-time":"2024-06-20T07:08:27Z","timestamp":1718867307000},"source":"Crossref","is-referenced-by-count":2,"title":["Pneumo-peritoneum, pneumo-retroperitoneum and subcutaneous emphysema following endoscopic retrograde cholangiopancreatography with sphincterotomy\u2014an uncommon complication case report"],"prefix":"10.1093","volume":"2024","author":[{"given":"S","family":"Premakrishna","sequence":"first","affiliation":[{"name":"Department of Anaesthesia, Jaffna Teaching Hospital , Jaffna 40000 , Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sreekanthan","family":"Gobishangar","sequence":"additional","affiliation":[{"name":"Department of Surgery , Faculty of Medicine, , Post Box 57, Jaffna , Sri Lanka"},{"name":"University of Jaffna , Faculty of Medicine, , Post Box 57, Jaffna , Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jude Selvakumar","family":"Nilojan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Jaffna Teaching Hospital , Jaffna 40000 , Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gnanapragasam","family":"Vaikunthan","sequence":"additional","affiliation":[{"name":"Department of Anaesthesia, Jaffna Teaching Hospital , Jaffna 40000 , Srilanka"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jothini","family":"Thirunavukkarasu","sequence":"additional","affiliation":[{"name":"Department of Surgery , Faculty of Medicine, , Post Box 57, Jaffna , Sri Lanka"},{"name":"University of Jaffna , Faculty of Medicine, , Post Box 57, Jaffna , Sri Lanka"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,6,20]]},"reference":[{"key":"2024062007013189800_ref1","first-page":"93","article-title":"Post-ERCP complications, risk factors and management of complications","volume":"28","author":"Arslan","year":"2021","journal-title":"Laparosc Endosc Surg Sci"},{"key":"2024062007013189800_ref2","first-page":"746","article-title":"Comparison of early and delayed diagnosis of mortality in ERCP perforations: a high-volume patient experience","volume":"26","author":"Borazan","year":"2020","journal-title":"Ulus Travma Derg"},{"key":"2024062007013189800_ref3","first-page":"216","article-title":"Subcutaneous emphysema, pneumothorax and pneumomediastinum following endoscopic sphincterotomy","volume":"3","author":"Schiavon","year":"2010","journal-title":"Gastroenterol Res"},{"key":"2024062007013189800_ref4","first-page":"29","volume-title":"Prevention and Management of ERCP-Related Complications","author":"Okano","year":"2021"},{"key":"2024062007013189800_ref5","first-page":"w20199","article-title":"Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography","volume":"150","author":"Lehmann","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"2024062007013189800_ref6","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1155\/2010\/289135","article-title":"Successful nonsurgical treatment of pneumomediastinum, pneumothorax, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema following ERCP","volume":"2010","author":"Fujii","year":"2010","journal-title":"Gastroenterol Res Pract"},{"key":"2024062007013189800_ref7","first-page":"19","article-title":"Recent advances in prevention and management of endoscopic retrograde cholangiopancreatography-related duodenal perforation","volume":"16","author":"Zhu","year":"2021","journal-title":"Wideochirurgia I Inne Tech 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emphysema","volume":"41","author":"Vitito","year":"2018","journal-title":"Gastroenterol Nurs"},{"key":"2024062007013189800_ref11","first-page":"441","article-title":"The management of perforation after endoscopic retrograde cholangiopancreatography (ERCP)","volume":"22","author":"Tavusbay","year":"2016","journal-title":"Turkish J Trauma Emerg Surg"},{"key":"2024062007013189800_ref12","doi-asserted-by":"crossref","first-page":"1419","DOI":"10.1016\/j.radcr.2023.12.064","article-title":"Concurrent acute pancreatitis, pneumoperitoneum, pneumoretroperitoneum, and pneumomediastinum following ERCP-related perforation: a rare and insightful case study","volume":"19","author":"Nadeem","year":"2024","journal-title":"Radiol Case Rep"},{"key":"2024062007013189800_ref13","doi-asserted-by":"crossref","first-page":"1990","DOI":"10.1007\/s10620-012-2150-3","article-title":"Pneumothorax following ERCP: report of four cases and review of the literature","volume":"57","author":"Schepers","year":"2012","journal-title":"Dig Dis Sci"},{"key":"2024062007013189800_ref14","doi-asserted-by":"crossref","first-page":"329","DOI":"10.1002\/jgh3.12095","article-title":"Post-endoscopic retrograde cholangiopancreatography pneumothorax: report of two cases and literature review","volume":"2","author":"Jha","year":"2018","journal-title":"JGH Open"},{"key":"2024062007013189800_ref15","doi-asserted-by":"crossref","first-page":"31","DOI":"10.4236\/ojgas.2016.62005","article-title":"Retroperitoneal air after ERCP with Sphincterotomy: frequency and clinical significance &lt;\/br&gt;\u2014retroperitoneal air after Sphincterotomy","volume":"06","author":"Mendez","year":"2016","journal-title":"Open J Gastroenterol"}],"container-title":["Journal of Surgical Case 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