# A Fatal Cascade Following Endoscopic Retrograde Cholangiopancreaticography (ERCP) Complicated by Pancreatitis, Duodenal Perforation, Gastrointestinal Hemorrhage, and Multi-organ Failure

## TL;DR

A 65-year-old woman died after a series of severe complications following an ERCP procedure, highlighting the risks of this medical intervention.

## Contribution

This case report highlights the rare but fatal cascade of complications following ERCP-induced pancreatitis.

## Key findings

- Post-ERCP pancreatitis can lead to walled-off fluid collections.
- Severe complications such as duodenal perforation and multi-organ failure can follow.
- Vigilant monitoring is critical to prevent mortality in such cases.

## Abstract

Endoscopic retrograde cholangiopancreatography (ERCP) is a valuable diagnostic and therapeutic procedure that carries inherent risks, with pancreatitis being a significant complication. While most cases resolve without major sequelae, severe complications can occur. A 65-year-old female with a history of pancreatitis developed post-ERCP pancreatitis following stent placement. The patient subsequently presented with walled-off fluid collections and experienced a catastrophic course complicated by duodenal perforation, severe hemorrhage, and multi-organ dysfunction, ultimately resulting in mortality. This case emphasizes the potential for life-threatening complications following post-ERCP pancreatitis and underscores the importance of vigilant monitoring and prompt intervention in managing these patients.