Become familiar with the possible adverse events following ERCP. Understand the role of CT imaging in the diagnosis of ERCP-induced complications.

Endoscopic retrograde cholangiopancreatography (ERCP) was initially introduced as a diagnostic procedure, but this indication was mostly abandoned because of its invasive nature and significant rate of complications. It remains a firmly established therapeutic modality for pancreatic and biliary disorders, and can often obviate the need for surgery. The incidences of adverse events are reported as 5% to 10%, depending on the complexity of the procedure, the underlying diagnosis, and patient co-morbidities.1,2 Some of the complications are related to endoscopy, such as perforation, bleeding, and issues...

This review aims to provide an increased familiarity with the interpretation of post-ERCP studies, and to also highlight specific situations that require interventional or surgical treatment. Procedural complications were identified by searching the medical records and imaging studies of all patients who underwent an ERCP at our institution between January 2015 and December 2018. A total number of 781 procedures were performed, of which there were 24 complications (3%) requiring an imaging exam (Table 1). These are summarized below, where we’ll discuss the most salient...

CT is a valuable imaging tool in diagnosing the cause of acute abdominal pain following ERCP, as laboratory test results and physical examination findings have limited value. It allows differentiation between common complications such as acute pancreatitis and perforation, and other less frequent adverse events. Even if unusual, these complications should be identified and recognized, in order to provide adequate management.

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