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Fig. 1.
Initial cholangiogram revealing two 8 mm stones in the common bile duct
Fig. 2.
Control cholangiogram at the end of the ERCP procedure confirming stone clearance. No obvious radiologic signs of perforation were seen by the examiner
Fig. 3.
Echogenic particles flowing within the portal vein and inferior vena cava, and multiple non-shadowing echogenic foci within the liver parenchyma consistent with the presence of intrahepatic portal venous gas
Fig. 4.
Contrast-enhanced CT scan of the abdomen performed 4 hours after the second abdominal ultrasound examination showing massive retropneumoperitoneum (arrows) and a post-cholecystectomy drainage tube. Gas is no longer visible in the liver or portal venous system
Fig. 5.
Image of the retroperitoneal cavity taken during the surgical intervention