[Perforations following endoscopic retrograde cholangiopancreatography (ERCP)]

Endoscopic retrograde cholangiopancreatography (ERCP) associated with sphincterotomy is a useful procedure that is widely used in cases of choledocholithiasis and bile duct obstruction. In spite of being a safe test, there is a risk of complications like pancreatitis, haemorrhaging or perforation. Post-ERCP duodenal perforation is a rare event but has serious consequences if it is not treated early. The lesion mechanism, the place and extension of the perforation, as well as the clinical picture and radiographic findings will guide patient management, which must be individualised and constantly reevaluated. Its mortality is closely related to diagnostic and therapeutic delay. In those cases where a conservative attitude is adopted, close vigilance will be maintained facing the possibility of a worsening of the clinical picture and a change in its management.