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

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.