Two-stage complications after endoscopic retrograde cholangiopancreatography comprising early retroperitoneal perforation and delayed biliary stent migration: A case report

Figure 1 Early suspected retroperitoneal perforation after endoscopic retrograde cholangiopancreatography. A: Fluoroscopic image during endoscopic retrograde cholangiopancreatography showing dilatation of the intra- and extrahepatic bile ducts, with an approximately 1.2 cm filling defect in the mid-to-upper common bile duct. During gallstone extraction, contrast extravasation was observed and the stone could no longer be clearly delineated; B and C: Axial computed tomography images obtained the following day showing pneumobilia and extensive retroperitoneal extraluminal gas with mediastinal extension, raising suspicion of early retroperitoneal perforation.