Figure 9b. Fluid collection secondary to duodenal perforation in a 79-year-old woman. The patient underwent sphincterotomy and placement of a stent in the pancreatic duct. CT was performed with oral contrast material 7 days after ERCP. (a) CT scan shows thickening of the wall of the duodenum (solid arrow). An extraluminal collection of air and contrast material lies posterior to the duodenum (open arrow). There is thickening of the Gerota fascia on the right side. (b) CT scan obtained inferior to a shows fluid in the right anterior pararenal space (arrow), a finding compatible with leakage of enteric contents from the duodenum. The perforation was treated conservatively, and follow-up CT did not show progression of the fluid collection. The patient recovered within 3 weeks.