Retroduodenal perforation is considered a rare but serious complication of endoscopic papillotomy. We report on a patient suffering from a stenotic occlusion of the ductus hepatico-choledochus on whom a pre-cut via needle-knife was performed in order to place a stent. Hours after the procedure, the patient developed an extensive pneumoretroperitoneum, pneumopericardium and scrotal emphysema. The later have not been reported in relevant literature so far.