Unusual occurrence of massive subcutaneous emphysema during
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Endoscopic retrograde cholangiopancreatography (ERCP) is associated with retroperitoneal perforation in 2.1% of cases and is usually related to extensive sphincterotomy. Not infrequently, retroperitoneal air, pneumoperitoneum, pneumomediastinum, pneumothorax, and subcutaneous emphysema are also reported which may or may not be associated with retroperitoneal perforation. Usually, these conditions respond to conservative management. Recently, we encountered a case developing subcutaneous emphysema without pneumomediastinum and pneumothorax while undergoing ERCP. This communication aims at highlighting a variant of presentation of extraluminal air during ERCP and current status of surgical approach to such situations...

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