Portal venous gas as a complication of ERCP and endoscopic sphincterotomy.

We report a patient in whom portal venous gas occurred as a complication of endoscopic retrograde cholangiopancreatography and endoscopic sphincterotomy, presumably because of bleeding at the papilla that allowed gas to enter the duodenal wall and portal venous system. To our knowledge, four similar cases have been reported previously. Although these patients have had a benign clinical course with rapid resolution of the gas, they should be observed carefully for signs of duodenal bleeding or perforation.