Abstract
Endoscopic retrograde cholangiopancreatography (ERCP) is a frequently performed procedure in the management of hepatobiliary diseases that can be conducted as a therapeutic or diagnostic procedure. Also, it can be done with or without sphincterotomy and stent insertion. Hemorrhage is one of the most common post-ERCP complications, which can be presented as late as 10 days. Other complications include post-ERCP pancreatitis and perforation. Gut perforation during ERCP is rare but often lethal. Here we present a 35-year-old female who was admitted to the hospital through the ER as a case of obstructive jaundice with common bile duct (CBD) stone. ERCP with stent insertion was performed for the patient to relieve the obstruction; however, intra-procedural retroperitoneal perforation was encountered.