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Gastroenterology Research and Practice
Volume 2010, Article ID 289135, 7 pages
http://dx.doi.org/10.1155/2010/289135
Case Report

Successful Nonsurgical Treatment of Pneumomediastinum, Pneumothorax, Pneumoperitoneum, Pneumoretroperitoneum, and Subcutaneous Emphysema following ERCP

1Mayo Clinic, 13400 E Shea Blvd, Department of Internal Medicine, Phoenix, AZ 85259, USA
2Mayo Clinic, 13400 E Shea Blvd, Division of Gastroenterology and Hepatology, Phoenix, AZ 85259, USA

Received 9 February 2010; Revised 16 April 2010; Accepted 19 April 2010

Academic Editor: Mohamad A. Eloubeidi

Copyright © 2010 L. Fujii et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Complications related to endoscopic retrograde cholangiopancreatography (ERCP) include pancreatitis, hemorrhage, cholangitis, and perforation. ERCP-related perforation is uncommon, but mortality rates are high. Diagnosis requires a high clinical suspicion for early detection to allow optimal management of the perforation and a better prognosis. Treatment depends on the location and mechanism and increasingly involves nonoperative management. We report a case of successful nonsurgical treatment of a patient with extensive air involving the peritoneum, retroperitoneum, thorax, mediastinum, and subcutaneous tissues following an ERCP perforation.