<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2011-7582</journal-id>
<journal-title><![CDATA[Revista Colombiana de Cirugía]]></journal-title>
<abbrev-journal-title><![CDATA[rev. colomb. cir.]]></abbrev-journal-title>
<issn>2011-7582</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Cirugía]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2011-75822022000200318</article-id>
<article-id pub-id-type="doi">10.30944/20117582.858</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Disección aérea masiva tras CPRE: reporte de caso y revisión de la literatura]]></article-title>
<article-title xml:lang="en"><![CDATA[Massive air dissection after ERCP: case report and literature review]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Coronado-Sarmiento]]></surname>
<given-names><![CDATA[Juan Felipe]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valdivieso-Rueda]]></surname>
<given-names><![CDATA[Eduardo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[León-Barrera]]></surname>
<given-names><![CDATA[Óscar Javier]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Bucaramanga  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Santander</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Fundación ILDETECSA  ]]></institution>
<addr-line><![CDATA[Bucaramanga ]]></addr-line>
<country>Santander</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2022</year>
</pub-date>
<volume>37</volume>
<numero>2</numero>
<fpage>318</fpage>
<lpage>323</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S2011-75822022000200318&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S2011-75822022000200318&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S2011-75822022000200318&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción.  Por ser un procedimiento de mínima invasión, la colangiopancreatografía retrógrada endoscópica (CPRE) es el procedimiento más utilizado para el manejo de la patología litiásica biliar. Sin embargo, puede presentar complicaciones que comprometen la vida del paciente.  Caso clínico.  Paciente masculino de 63 años es llevado a CPRE por una coledocolitiasis recidivante gigante. Durante el procedimiento presentó una disección aérea masiva con neumotórax bilateral a tensión, secundarios a una perforación duodenal, que derivó en una fístula bilio-retroperitoneal. Se trató de forma conservadora con una adecuada evolución.  Discusión.  Se han descrito pocos casos de neumotórax como complicación de la CPRE. Se considera que este es el primer caso publicado de neumotórax a tensión manejado exitosamente de forma conservadora.  Conclusión.  El diagnóstico temprano de las disecciones aéreas es el único predictor independiente que podría cambiar el curso clínico de esta patología y su manejo dependerá de la experticia del cirujano y del estado clínico del paciente.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction.  Because it is a minimally invasive procedure, endoscopic retrograde cholangiopancreatography (ERCP) is the most widely used procedure for the management of biliary lithiasic pathology. However, it can present complications that compromise the life of the patient.  Clinical case.  A 63-year-old male patient is taken to ERCP for a giant recurrent choledocholithiasis. During the procedure presented a massive air dissection with bilateral tension pneumothorax, secondary to a duodenal perforation, which led to a bilio-retroperitoneal fistula. It was treated conservatively with adequate evolution.  Discussion.  Few cases of pneumothorax have been described as a complication of ERCP. This is considered to be the first published case of tension pneumothorax successfully managed conservatively.  Conclusion.  Early diagnosis of air dissections is the only independent predictor that could change the clinical course of this pathology, and its management will depend on the expertise of the surgeon and the clinical status of the patient.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[colangiopancreatografía retrógrada endoscópica]]></kwd>
<kwd lng="es"><![CDATA[neumotórax]]></kwd>
<kwd lng="es"><![CDATA[complicación]]></kwd>
<kwd lng="es"><![CDATA[cirugía]]></kwd>
<kwd lng="es"><![CDATA[fístula biliar]]></kwd>
<kwd lng="es"><![CDATA[prótesis]]></kwd>
<kwd lng="en"><![CDATA[endoscopic retrograde cholangiopancreatography]]></kwd>
<kwd lng="en"><![CDATA[pneumothorax]]></kwd>
<kwd lng="en"><![CDATA[complication]]></kwd>
<kwd lng="en"><![CDATA[surgery]]></kwd>
<kwd lng="en"><![CDATA[biliary fistula]]></kwd>
<kwd lng="en"><![CDATA[stent]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Buxbaum]]></surname>
<given-names><![CDATA[JL]]></given-names>
</name>
<name>
<surname><![CDATA[Abbas Fehmi]]></surname>
<given-names><![CDATA[SM]]></given-names>
</name>
<name>
<surname><![CDATA[Sultan]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fishman]]></surname>
<given-names><![CDATA[DS]]></given-names>
</name>
<name>
<surname><![CDATA[Qumseya]]></surname>
<given-names><![CDATA[BJ]]></given-names>
</name>
<name>
<surname><![CDATA[Cortessis]]></surname>
<given-names><![CDATA[VK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ASGE guideline on the role of endoscopy in the evaluation and management of choledocholithiasis]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2019</year>
<volume>89</volume>
<page-range>1075-1105.e15</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Chandrasekhara]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Khashab]]></surname>
<given-names><![CDATA[MA]]></given-names>
</name>
<name>
<surname><![CDATA[Muthusamy]]></surname>
<given-names><![CDATA[VR]]></given-names>
</name>
<name>
<surname><![CDATA[Acosta]]></surname>
<given-names><![CDATA[RD]]></given-names>
</name>
<name>
<surname><![CDATA[Agrawal]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Bruining]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Adverse events associated with ERCP]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2017</year>
<volume>85</volume>
<page-range>32-47</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Szary]]></surname>
<given-names><![CDATA[NM]]></given-names>
</name>
<name>
<surname><![CDATA[Al-Kawas]]></surname>
<given-names><![CDATA[FH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Complications of endoscopic retrograde cholangiopancreatography: How to avoid and manage them]]></article-title>
<source><![CDATA[Gastroenterol Hepatol]]></source>
<year>2013</year>
<volume>9</volume>
<page-range>496-504</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Reyes]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Pinto-Carta]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sierra-Arango]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Cabrera- Vargas]]></surname>
<given-names><![CDATA[LF]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Embolía pulmonar aérea secundaria a colangiopancreatografía retrógrada endoscópica en una paciente con trasplante hepático. Reporte de caso]]></article-title>
<source><![CDATA[Rev Colomb Gastroenterol]]></source>
<year>2018</year>
<volume>33</volume>
<page-range>464-8</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Navarrete]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Castillo]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Caracci]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Vargas]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Gobelet]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Robles]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Wide percutaneous access to pancreatic necrosis with self-expandable stent: New application (with video)]]></article-title>
<source><![CDATA[astrointest Endosc]]></source>
<year>2011</year>
<volume>73</volume>
<page-range>609-10</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Williams]]></surname>
<given-names><![CDATA[EJ]]></given-names>
</name>
<name>
<surname><![CDATA[Taylor]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Fairclough]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Hamlyn]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Logan]]></surname>
<given-names><![CDATA[RF]]></given-names>
</name>
<name>
<surname><![CDATA[Martin]]></surname>
<given-names><![CDATA[D.]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for complication following ERCP: results of a large-scale, prospective multicenter study]]></article-title>
<source><![CDATA[Endoscopy]]></source>
<year>2007</year>
<volume>39</volume>
<page-range>793-801</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Hui]]></surname>
<given-names><![CDATA[CK]]></given-names>
</name>
<name>
<surname><![CDATA[Lai]]></surname>
<given-names><![CDATA[KC]]></given-names>
</name>
<name>
<surname><![CDATA[Yuen]]></surname>
<given-names><![CDATA[MF]]></given-names>
</name>
<name>
<surname><![CDATA[Lam]]></surname>
<given-names><![CDATA[SK]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tension pneumothorax complicating ERCP in a patient with a Billroth II gastrectomy]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2001</year>
<volume>54</volume>
<page-range>254-6</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Yoo]]></surname>
<given-names><![CDATA[JH]]></given-names>
</name>
<name>
<surname><![CDATA[Shin]]></surname>
<given-names><![CDATA[SJ]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[KM]]></given-names>
</name>
<name>
<surname><![CDATA[Choi]]></surname>
<given-names><![CDATA[JM]]></given-names>
</name>
<name>
<surname><![CDATA[Wi]]></surname>
<given-names><![CDATA[JO]]></given-names>
</name>
<name>
<surname><![CDATA[Kim]]></surname>
<given-names><![CDATA[DH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Risk factors for perforations associated with endoscopic submucosal dissection in gastric lesions: Emphasis on perforation type]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2012</year>
<volume>26</volume>
<page-range>2456-64</page-range></nlm-citation>
</ref>
<ref id="B9">
<label>9</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Lagoudianakis]]></surname>
<given-names><![CDATA[EE]]></given-names>
</name>
<name>
<surname><![CDATA[Tsekouras]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Papadima]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Genetzakis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Pattas]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Giannopoulos]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumothorax complicating endoscopic sphincterotomy successfully treated conservatively]]></article-title>
<source><![CDATA[Acta Gastroenterol Belg]]></source>
<year>2006</year>
<volume>69</volume>
<page-range>334-6</page-range></nlm-citation>
</ref>
<ref id="B10">
<label>10</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Schepers]]></surname>
<given-names><![CDATA[NJ]]></given-names>
</name>
<name>
<surname><![CDATA[Van Buuren]]></surname>
<given-names><![CDATA[HR]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumothorax following ERCP: Report of four cases and review of the literature]]></article-title>
<source><![CDATA[Dig Dis Sci]]></source>
<year>2012</year>
<volume>57</volume>
<page-range>1990-5</page-range></nlm-citation>
</ref>
<ref id="B11">
<label>11</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Sampaziotis]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Wiles]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Shaukat]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
<name>
<surname><![CDATA[Dickinson]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Bilateral pneumothorax and subcutaneous emphysema following endoscopic retrograde cholangiopancreatography with sphincterectomy]]></article-title>
<source><![CDATA[Diagn Ther Endosc]]></source>
<year>2010</year>
<page-range>1-3</page-range></nlm-citation>
</ref>
<ref id="B12">
<label>12</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Maunder]]></surname>
<given-names><![CDATA[RJ]]></given-names>
</name>
<name>
<surname><![CDATA[Pierson]]></surname>
<given-names><![CDATA[DJ]]></given-names>
</name>
<name>
<surname><![CDATA[Hudson]]></surname>
<given-names><![CDATA[LD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Subcutaneous and mediastinal emphysema, pathophysiology, diagnosis and management]]></article-title>
<source><![CDATA[JAMA]]></source>
<year>1984</year>
<volume>144</volume>
<page-range>1447-53</page-range></nlm-citation>
</ref>
<ref id="B13">
<label>13</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Ferrara]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[Luigiano]]></surname>
<given-names><![CDATA[C]]></given-names>
</name>
<name>
<surname><![CDATA[Billi]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Jovine]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cinquantini]]></surname>
<given-names><![CDATA[F]]></given-names>
</name>
<name>
<surname><![CDATA[D&#8217;Imperio]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Pneumothorax, pneumomediastinum, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema after ERCP]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2009</year>
<volume>69</volume>
<page-range>1398-401</page-range></nlm-citation>
</ref>
<ref id="B14">
<label>14</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kocaman]]></surname>
<given-names><![CDATA[O]]></given-names>
</name>
<name>
<surname><![CDATA[Sipahi]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Çubukçu]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Baykara]]></surname>
<given-names><![CDATA[ZN]]></given-names>
</name>
<name>
<surname><![CDATA[Hülagü]]></surname>
<given-names><![CDATA[S]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Porous diaphragm syndrome after ERCP in a patient with bile duct stricture]]></article-title>
<source><![CDATA[Turkish Journal of Gastroenterology]]></source>
<year>2009</year>
<volume>20</volume>
<page-range>157-8</page-range></nlm-citation>
</ref>
<ref id="B15">
<label>15</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Paspatis]]></surname>
<given-names><![CDATA[GA]]></given-names>
</name>
<name>
<surname><![CDATA[Arvanitakis]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Dumonceau]]></surname>
<given-names><![CDATA[J-M]]></given-names>
</name>
<name>
<surname><![CDATA[Barthet]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Saunders]]></surname>
<given-names><![CDATA[B]]></given-names>
</name>
<name>
<surname><![CDATA[Turino]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Diagnosis and management of iatrogenic endoscopic perforations: European Society of Gastrointestinal Endoscopy (ESGE) Position Statement - Update 2020]]></article-title>
<source><![CDATA[Endoscopy]]></source>
<year>2020</year>
<volume>52</volume>
<page-range>792-810</page-range></nlm-citation>
</ref>
<ref id="B16">
<label>16</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Song]]></surname>
<given-names><![CDATA[SY]]></given-names>
</name>
<name>
<surname><![CDATA[Lee]]></surname>
<given-names><![CDATA[KS]]></given-names>
</name>
<name>
<surname><![CDATA[Na]]></surname>
<given-names><![CDATA[KJ]]></given-names>
</name>
<name>
<surname><![CDATA[Ahn]]></surname>
<given-names><![CDATA[BH]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tension pneumothorax after endoscopic retrograde pancreatocholangiogram]]></article-title>
<source><![CDATA[J Korean Med Sci]]></source>
<year>2009</year>
<volume>24</volume>
<page-range>173-5</page-range></nlm-citation>
</ref>
<ref id="B17">
<label>17</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Han]]></surname>
<given-names><![CDATA[ML]]></given-names>
</name>
<name>
<surname><![CDATA[Wu]]></surname>
<given-names><![CDATA[YM]]></given-names>
</name>
<name>
<surname><![CDATA[Liu]]></surname>
<given-names><![CDATA[KL]]></given-names>
</name>
<name>
<surname><![CDATA[Su]]></surname>
<given-names><![CDATA[WC]]></given-names>
</name>
<name>
<surname><![CDATA[Wang]]></surname>
<given-names><![CDATA[HP]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Tension pneumothorax after an ERCP in a patient with hepatic hydrothorax and sealed-off perforated duodenal ulcer]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2008</year>
<volume>68</volume>
<page-range>771-2</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
