BMJ Case Reports 2017; doi:10.1136/bcr-2017-220997
  • Images in…

Localised pneumoperitoneum following liver mass biopsy in the setting of post-ERCP pneumobilia

  1. Imad Nassif
  1. Department of Internal Medicine, Kansas University School of Medicine - Wichita, Wichita, Kansas, USA
  1. Correspondence to Fredy Nehme, nehme.fredy{at}
  • Accepted 23 June 2017
  • Published 17 July 2017


A 72-year-old woman presented with a 1-week history of fatigue, weight loss and painless jaundice. Liver chemistries confirmed cholestasis with hyperbilirubinaemia of 25.6 mg/dL. An abdominal CT scan revealed multifocal liver lesions and dilation of intrahepatic and extrahepatic bile ducts. On endoscopic retrograde cholangiopancreatography (ERCP), a common bile duct stricture was found requiring dilation and insertion of a biliary stent. Cholangiogram demonstrated free bile drainage without contrast medium leakage. The patient then underwent CT-guided biopsy of a left lobe liver mass. On the next day, she complained of constant abdominal …

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