Figure 4b. Perforation of the right hepatic duct in a 35-year-old man with a history of sclerosing cholangitis. Dilation of the common bile duct was performed for a stricture. Owing to persistent pain, fever, and retroperitoneal fluid at CT, repeat ERCP was performed and showed leakage of contrast material from the right hepatic duct. A stent was placed, and the patient recovered within 1 week. CT was performed with oral and intravenous contrast material 2 days after ERCP. (a) CT scan shows fluid and extensive inflammation in the retroperitoneum due to bile leakage. The right ureter is surrounded (open arrow). The fluid tracked inferiorly from the gallbladder fossa. Solid arrow = left ureter. (b) CT scan shows inflammatory change and fluid in the presacral space (*). Arrow = rectum.