title: Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after unsuccessful ERCP: a case report.
abstract: BACKGROUND
  The presence of subcutaneous emphysema, pneumomediastinum and pneumoperitoneum simultaneously is a rare complication of upper gastrointestinal endoscopy that usually indicates free perforation to the peritoneal cavity or the retroperitoneal space.
  
  
  METHODS
  We report an unusual case of a self-limited subcutaneous emphysema, pneumomediastinum and pneumoperitoneum following an unsuccessful ERCP for removal of a common bile duct stone.
  
  
  CONCLUSIONS
  There was no radiological evidence of peritoneal or retroperitoneal perforation. This complication is distinct from pneumomediastinum and pneumoperitoneum due to perforation, and must be recognized, because it is benign and needs no surgical or radiological intervention.
authors.affiliation: Department of Surgery, "Sismanoglio" General Hospital of Athens, Athens, Greece. sakellaridis_t@yahoo.gr.
authors.forename: Konstantinos
authors.initials: K
authors.lastname: Alexiou
authors.forename: Timothy
authors.initials: T
authors.lastname: Sakellaridis
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Sikalias
authors.forename: Ioannis
authors.initials: I
authors.lastname: Karanikas
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Economou
authors.forename: Giorgios
authors.initials: G
authors.lastname: Antsaklis