Closure of a persistent sphincterotomy-related duodenal perforation by placement of a covered self-expandable metallic biliary stent

Figure 1 Free gas in the retroperitoneal space.

Figure 2 Computed tomography scan showing the presence of air in the retroperitoneal space and subcutaneous emphysema.

Figure 3 The laceration is evident just below the lower end of the bile duct.

Figure 4 Injection of contrast from the endoscope enables visualization of the fistulous tract. The bile duct is also delineated with the presence of gas.

Figure 5 The covered self-expandable metallic biliary stent covers the laceration.

Figure 6 Covered self-expandable metallic biliary stent and nasobiliary catheter in place.