<?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>0120-9957</journal-id>
<journal-title><![CDATA[Revista colombiana de Gastroenterología]]></journal-title>
<abbrev-journal-title><![CDATA[Rev. colomb. Gastroenterol.]]></abbrev-journal-title>
<issn>0120-9957</issn>
<publisher>
<publisher-name><![CDATA[Asociación Colombiana de Gastroenterología  ]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S0120-99572026000100102</article-id>
<article-id pub-id-type="doi">10.22516/25007440.1379</article-id>
<title-group>
<article-title xml:lang="en"><![CDATA[An Uncommon Complication of Post-ERCP Pancreatitis and Duodenal Perforation: Case Report]]></article-title>
<article-title xml:lang="es"><![CDATA[Una complicación poco usual de pancreatitis y perforación duodenal pos-CPRE: reporte de caso]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Serna-Trejos]]></surname>
<given-names><![CDATA[Juan Santiago]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peña-Ortiz]]></surname>
<given-names><![CDATA[Christian]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Castro-Galvis]]></surname>
<given-names><![CDATA[Carlos Andrés]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Valeta-Medina]]></surname>
<given-names><![CDATA[Jhon Jairo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Calle-García]]></surname>
<given-names><![CDATA[Esteban]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Vallejo-Díaz]]></surname>
<given-names><![CDATA[José Fernando]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Clínica Sebastián de Belalcázar  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Universidad del Valle  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af3">
<institution><![CDATA[,Pontificia Universidad Javeriana  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af4">
<institution><![CDATA[,Pontificia Universidad Javeriana  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af5">
<institution><![CDATA[,Universidad Libre  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<aff id="Af6">
<institution><![CDATA[,Clínica Imbanaco  ]]></institution>
<addr-line><![CDATA[Cali ]]></addr-line>
<country>Colombia</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2026</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2026</year>
</pub-date>
<volume>41</volume>
<numero>1</numero>
<fpage>102</fpage>
<lpage>107</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_arttext&amp;pid=S0120-99572026000100102&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_abstract&amp;pid=S0120-99572026000100102&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.co/scielo.php?script=sci_pdf&amp;pid=S0120-99572026000100102&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a fundamental therapeutic procedure in biliopancreatic disease, although it is associated with potentially severe complications, including post-ERCP pancreatitis (PEP) and duodenal perforation. The latter is rare but carries a high mortality rate.  Case Presentation: A 52-year-old previously healthy woman underwent ERCP for obstructive choledocholithiasis. Within the first 24 hours, she developed abdominal pain, distension, vomiting, and hemodynamic instability, with elevated serum amylase levels initially consistent with PEP. Due to clinical deterioration, contrast-enhanced computed tomography revealed pneumoretroperitoneum and extensive free fluid, findings suggestive of duodenal perforation. Emergency laparotomy confirmed a perforation in the second portion of the duodenum, which was managed with primary repair and abdominal lavage. The postoperative course was complicated, requiring reinterventions, open abdomen management, and intensive care support.  Discussion: The coexistence of PEP and duodenal perforation is exceptional and significantly complicates early diagnosis due to overlapping clinical manifestations. Early computed tomography and timely surgical decision-making were decisive in management.  Conclusion: This case highlights the need for high clinical suspicion and early imaging evaluation in patients with atypical post-ERCP evolution, as well as the importance of a staged, multidisciplinary management approach in highly complex clinical scenarios.]]></p></abstract>
<abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción:  La colangiopancreatografía retrógrada endoscópica (CPRE) es un procedimiento terapéutico fundamental en patología biliopancreática, aunque asociada a complicaciones potencialmente graves como la pancreatitis pos-CPRE (PEP) y la perforación duodenal, esta última poco frecuente, pero con alta mortalidad.  Presentación del caso:  Mujer de 52 años, previamente sana, sometida a CPRE por coledocolitiasis obstructiva. En las primeras 24 horas desarrolló dolor abdominal, distensión, vómito e inestabilidad hemodinámica, con elevación de amilasa sérica compatible inicialmente con PEP. Ante el deterioro clínico, la tomografía computarizada contrastada evidenció neumorretroperitoneo y líquido libre extenso, sugestivos de perforación duodenal. Se realizó una laparotomía urgente, en la que se confirmó una perforación en la segunda porción del duodeno, manejada con rafia primaria y lavado abdominal. La evolución fue tórpida, por lo que requirió reintervenciones, manejo de abdomen abierto y soporte intensivo.  Discusión: La coexistencia de PEP y perforación duodenal es excepcional y dificulta el diagnóstico temprano por superposición clínica. La tomografía computarizada temprana y la toma de decisiones quirúrgicas oportunas fueron determinantes en el abordaje.  Conclusión:  Este caso resalta la necesidad de alta sospecha clínica y evaluación imagenológica precoz en pacientes con evolución atípica pos-CPRE, así como un manejo multidisciplinario escalonado en escenarios de alta complejidad.]]></p></abstract>
<kwd-group>
<kwd lng="en"><![CDATA[Endoscopic retrograde cholangiopancreatography]]></kwd>
<kwd lng="en"><![CDATA[pancreatitis]]></kwd>
<kwd lng="en"><![CDATA[intestinal perforation]]></kwd>
<kwd lng="es"><![CDATA[Colangiopancreatografía retrógrada endoscópica]]></kwd>
<kwd lng="es"><![CDATA[pancreatitis]]></kwd>
<kwd lng="es"><![CDATA[perforación intestinal]]></kwd>
</kwd-group>
</article-meta>
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