{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T23:49:27Z","timestamp":1780444167619,"version":"3.54.1"},"reference-count":7,"publisher":"Oxford University Press (OUP)","issue":"9","license":[{"start":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T00:00:00Z","timestamp":1726963200000},"content-version":"vor","delay-in-days":21,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,9,1]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:p>Endoscopic retrograde cholangiopancreatography is a complex procedure with a significant risk of severe consequences. We herein report a 56-year-old Middle Eastern female who was diagnosed with acute ascending cholangitis. Endoscopic retrograde cholangiopancreatography was performed with gallstone absorption and stent implanting. However, the patient developed significant pneumothorax; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema of the abdomen, chest, right arm and shoulder, face and right orbital area. Radiological studies demonstrated no evidence of perforation on bowel obstruction. The patient was treated successfully with good results and post-operative follow-up was unremarkable. In conclusion, air leakage following endoscopic retrograde cholangiopancreatography without evidence of perforation is extremely rare. While pneumothorax development usually requires thoracostomy; pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema are usually treated conservatively.<\/jats:p>","DOI":"10.1093\/omcr\/omae118","type":"journal-article","created":{"date-parts":[[2024,9,22]],"date-time":"2024-09-22T10:57:17Z","timestamp":1727002637000},"source":"Crossref","is-referenced-by-count":3,"title":["Right pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema as rare complications after ERCP: a case report"],"prefix":"10.1093","volume":"2024","author":[{"given":"Ghassan","family":"Bayat","sequence":"first","affiliation":[{"name":"Plymouth University Hospitals NHS Trust , Plymouth, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Haneyah","sequence":"additional","affiliation":[{"name":"Al-balqa Applied University , Hashemite Kingdom of Jordan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Merjaneh","sequence":"additional","affiliation":[{"name":"Zahi Azrak Hospital Division of Gastroenterology, Department of Internal Medicine, , Aleppo, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2215-7506","authenticated-orcid":false,"given":"Sultaneh","family":"Haddad","sequence":"additional","affiliation":[{"name":"Children\u2019s Hospital Division of Pediatric, , Damascus, Syrian Arab Republic"},{"name":"Stemosis for Scientific Research , Damascus, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aboud","family":"Thaljah","sequence":"additional","affiliation":[{"name":"University of Aleppo Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, , Aleppo, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Zambakjian","sequence":"additional","affiliation":[{"name":"University of Aleppo Division of Gastroenterology, Department of Internal Medicine, Faculty of Medicine, , Aleppo, Syrian Arab Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5644-6325","authenticated-orcid":false,"given":"Mike","family":"Ghabally","sequence":"additional","affiliation":[{"name":"University of Aleppo Division of Cardiology, Department of Internal Medicine, Faculty of Medicine, , Aleppo, Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,9,22]]},"reference":[{"key":"2024092210571073600_ref1","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":"2024092210571073600_ref2","doi-asserted-by":"crossref","first-page":"E195","DOI":"10.1055\/s-2007-966416","article-title":"Bilateral pneumothorax following endoscopic retrograde cholangiopancreatography: a case report","volume":"39 Suppl 1","author":"Markogiannakis","year":"2007","journal-title":"Endoscopy"},{"key":"2024092210571073600_ref3","first-page":"216","article-title":"Subcutaneous emphysema, pneumothorax and Pneumomediastinum following endoscopic Sphincterotomy","volume":"3","author":"Schiavon","year":"2010","journal-title":"Gastroenterology Res"},{"key":"2024092210571073600_ref4","doi-asserted-by":"publisher","first-page":"w20199","DOI":"10.4414\/smw.2020.20199","article-title":"Systematic review of pneumothoraces after endoscopic retrograde cholangiopancreatography","volume":"150","author":"Lehmann","year":"2020","journal-title":"Swiss Med Wkly"},{"key":"2024092210571073600_ref5","doi-asserted-by":"crossref","first-page":"e15","DOI":"10.1016\/j.amjmed.2009.12.040","article-title":"Massive subcutaneous emphysema after endoscopic retrograde cholangiopancreatography","volume":"123","author":"Seymann","year":"2010","journal-title":"Am J Med"},{"key":"2024092210571073600_ref6","doi-asserted-by":"crossref","first-page":"240","DOI":"10.1097\/SGA.0000000000000260","article-title":"Successful conservative treatment of an elderly patient with an ercp-related duodenal perforation associated with widespread subcutaneous emphysema","volume":"41","author":"Li","year":"2018","journal-title":"Gastroenterol Nurs"},{"key":"2024092210571073600_ref7","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 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