Endoscopy 1990; 22(4): 174-175
DOI: 10.1055/s-2007-1012833
© Georg Thieme Verlag KG Stuttgart · New York

Retroperitoneal Perforation during ERCP and Endoscopic Sphincterotomy: Causes, Clinical Features and Management

D. F. Martin, D. E. F. Tweedle
  • Departments of Radiology and Surgery, Gastroenterology Unit, University Hospital of South Manchester, Withington, Manchester, England
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Publication History

Publication Date:
17 March 2008 (online)


Eleven patients with retroperitoneal perforation complicating endoscopic management of bile duct obstruction were seen over a seven-year period. In nine patients endoscopic sphincterotomy or pre-cut papillotomy had been performed, but in two who had not undergone sphincterotomy perforation occurred because of the penetration of a guide wire during attempts to negotiate a malignant bile duct stricture. Eight out of eleven patients remained asymptomatic, and all recovered with conservative management. Asymptomatic retroperitoneal perforation can complicate therapeutic ERCP even when sphincterotomy is not performed, but conservative management is usually effective if the complications is recognized immediately.