Parenchymal Guidewire Perforation during ERCP: An Unappreciated Injury

Table 1

Subtypes of parenchymal guidewire injury with possible consequences.

Subtype	Location
A	Pancreatic duct into parenchyma
B	Pancreatic duct through parenchyma
C	Intrahepatic bile ducts into parenchyma
D	Intrahepatic bile ducts through parenchyma

Both types A and B may result in peripancreatic fluid collection due to pancreatitis alone (type A) or pancreatitis and leak from the pancreatic duct (type B).
Subcapsular haematoma or biloma results.
Free bile leak results.