Fig. 1.

During endoscopic retrograde cholangiopancreatography (ERCP), a 65-year-old female with sphincter of Oddi dysfunction experienced duodenal perforation (DP), which was recognised intraprocedurally and treated with endoluminal clipping. Twenty-four hours later, unenhanced multidetector CT obtained after peroral ingestion of enteral contrast medium (CM) and viewed at the bone window setting showed a well-opacified gastroduodenal lumen without extraluminal CM leak, consistent with sealed DP. Note the persistent extensive retroperitoneal air (+) and metallic clips (arrowhead in B)