TITLE:
Conservative Management of Esophageal Perforation Following an Endoscopic-Retrograde Cholangio-Pancreatography: A Case Report
AUTHORS:
Hynd Hedda, Kawtar Lahlali, Ismail Chaouche, Moulay Youssef Lamrani, Sidi Adil Ibrahimi, Dafr-allah Benajah
KEYWORDS:
Iatrogenic Esophageal Perforation, ERCP Complication, Conservative Management, Antibiotic Therapy, Case Report
JOURNAL NAME:
Open Access Library Journal,
Vol.12 No.10,
October
29,
2025
ABSTRACT: Background: Iatrogenic esophageal perforation (IEP) is a rare but life-threatening complication of upper endoscopic procedures. Aim: To present a case of conservative treatment of IEP following ERCP and to highlight the rationale behind non-operative management. Case Presentation: A 73-year-old woman underwent ERCP for the removal of a common bile duct stone. A 1-cm esophageal tear was detected intra-procedure. CT scan confirmed a contained perforation with cervical emphysema and pneumomediastinum. Conservative treatment with ceftriaxone plus metronidazole, proton pump inhibitor, total parenteral nutrition, and stepwise oral refeeding resulted in a favorable outcome without surgical intervention. Conclusion: This case illustrates that selected patients with contained esophageal perforation can be safely managed conservatively, provided early diagnosis, careful monitoring, and adherence to established criteria.