<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-6483</journal-id>
<journal-title><![CDATA[Endoscopia]]></journal-title>
<abbrev-journal-title><![CDATA[Endoscopia]]></abbrev-journal-title>
<issn>2444-6483</issn>
<publisher>
<publisher-name><![CDATA[Asociación Mexicana de Endoscopia Gastrointestinal A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-64832022000100034</article-id>
<article-id pub-id-type="doi">10.24875/end.22000028</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Manejo conservador de enfisema subcutáneo masivo, posterior a CPRE en Puebla, México]]></article-title>
<article-title xml:lang="en"><![CDATA[Conservative management of massive subcutaneous emphysema after ERCP in Puebla, Mexico]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ayala-Hernández]]></surname>
<given-names><![CDATA[Sandra G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Peña-Portillo]]></surname>
<given-names><![CDATA[Guadalupe K.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Espinosa-González]]></surname>
<given-names><![CDATA[José M.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[López-Loredo]]></surname>
<given-names><![CDATA[José A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Marín-Pardo]]></surname>
<given-names><![CDATA[Erwin I.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Pérez-Torres]]></surname>
<given-names><![CDATA[Guadalupe C.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Hospital Universitario de Puebla Servicio de Cirugía General ]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>México</country>
</aff>
<aff id="Af2">
<institution><![CDATA[,Hospital Universitario de Puebla Servicio de Endoscopia ]]></institution>
<addr-line><![CDATA[Puebla ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>03</month>
<year>2022</year>
</pub-date>
<volume>34</volume>
<numero>1</numero>
<fpage>34</fpage>
<lpage>36</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-64832022000100034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-64832022000100034&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-64832022000100034&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: La perforación duodenal es una complicación infrecuente de la colangiopancreatografía retrograda endoscópica (CPRE). Debido a la heterogeneidad de las perforaciones no existe consenso para su tratamiento  Caso clínico: Paciente con coledocolitiasis, que se somete a CPRE, identificando durante el procedimiento fuga del medio de contraste, posteriormente presentando enfisema subcutáneo masivo, tratado de forma exitosa con manejo conservador  Discusión: La perforación como complicación de procedimientos endoscópicos tienen una baja incidencia; entre los factores de riesgo asociados se encuentran el uso de precorte.  Conclusiones: El enfisema subcutáneo se presenta de manera infrecuente en pacientes con perforación, el tratamiento conservador dependerá del tipo de lesión.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Duodenal perforation is an infrequent complication of ERCP, due to the heterogeneity of perforations there is no consensus for its treatment.  Clinical case: Patient with choledocholithiasis, who underwent ERCP, identifying contrast medium leakage during the procedure, subsequently presenting massive subcutaneous emphysema, successfully treated with conservative management.  Discussion: Perforation as a complication of endoscopic procedures, have a low incidence, among the associated risk factors, are the use of precut.  Conclusions: Subcutaneous emphysema occurs infrequently in patients with perforation, conservative treatment will depend on the type of injury.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Enfisema subcutáneo]]></kwd>
<kwd lng="es"><![CDATA[Colangiopancreatografía retrograda endoscópica]]></kwd>
<kwd lng="es"><![CDATA[Perforación]]></kwd>
<kwd lng="en"><![CDATA[Subcutaneous emphysema]]></kwd>
<kwd lng="en"><![CDATA[Endoscopic retrograde cholangiopancreatography]]></kwd>
<kwd lng="en"><![CDATA[Perforation]]></kwd>
</kwd-group>
</article-meta>
</front><back>
<ref-list>
<ref id="B1">
<label>1</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Kumbhari]]></surname>
<given-names><![CDATA[V]]></given-names>
</name>
<name>
<surname><![CDATA[Sinha]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Reddy]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Afghani]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Cotsalas]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Patel]]></surname>
<given-names><![CDATA[YA]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Algorithm for the management of ERCP-related perforations]]></article-title>
<source><![CDATA[Gastrointest Endosc]]></source>
<year>2016</year>
<volume>83</volume>
<numero>5</numero>
<issue>5</issue>
<page-range>934-43</page-range></nlm-citation>
</ref>
<ref id="B2">
<label>2</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Patil]]></surname>
<given-names><![CDATA[NS]]></given-names>
</name>
<name>
<surname><![CDATA[Solanki]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Mishra]]></surname>
<given-names><![CDATA[PK]]></given-names>
</name>
<name>
<surname><![CDATA[Sharma]]></surname>
<given-names><![CDATA[BC]]></given-names>
</name>
<name>
<surname><![CDATA[Saluja]]></surname>
<given-names><![CDATA[SS]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[ERCP-related perforation:an analysis of operative outcomes in a large series over 12 years]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2020</year>
<volume>34</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>77-87</page-range></nlm-citation>
</ref>
<ref id="B3">
<label>3</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Cirocchi]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Kelly]]></surname>
<given-names><![CDATA[MD]]></given-names>
</name>
<name>
<surname><![CDATA[Griffiths]]></surname>
<given-names><![CDATA[EA]]></given-names>
</name>
<name>
<surname><![CDATA[Tabola]]></surname>
<given-names><![CDATA[R]]></given-names>
</name>
<name>
<surname><![CDATA[Sartelli]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Carlini]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[A systematic review of the management and outcome of ERCP related duodenal perforations using a standardized classification system]]></article-title>
<source><![CDATA[Surgeon]]></source>
<year>2017</year>
<volume>15</volume>
<numero>6</numero>
<issue>6</issue>
<page-range>379-87</page-range></nlm-citation>
</ref>
<ref id="B4">
<label>4</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Bill]]></surname>
<given-names><![CDATA[JG]]></given-names>
</name>
<name>
<surname><![CDATA[Smith]]></surname>
<given-names><![CDATA[Z]]></given-names>
</name>
<name>
<surname><![CDATA[Brancheck]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Elsner]]></surname>
<given-names><![CDATA[J]]></given-names>
</name>
<name>
<surname><![CDATA[Hobbs]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
<name>
<surname><![CDATA[Lang]]></surname>
<given-names><![CDATA[GD]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[The importance of early recognition in management of ERCP-related perforations]]></article-title>
<source><![CDATA[Surg Endosc]]></source>
<year>2018</year>
<volume>32</volume>
<numero>12</numero>
<issue>12</issue>
<page-range>4841-9</page-range></nlm-citation>
</ref>
<ref id="B5">
<label>5</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Samara]]></surname>
<given-names><![CDATA[AA]]></given-names>
</name>
<name>
<surname><![CDATA[Diamantis]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Perivoliotis]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Mavrovounis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Symeonidis]]></surname>
<given-names><![CDATA[D]]></given-names>
</name>
<name>
<surname><![CDATA[Baloyiannis]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Surgical versus non-operative initial management of post-endoscopic retrograde cholangiopancreatography perforation:a systematic review and meta-analysis]]></article-title>
<source><![CDATA[Ann Gastroenterol]]></source>
<year>2022</year>
<volume>35</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>95-101</page-range></nlm-citation>
</ref>
<ref id="B6">
<label>6</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Alexiou]]></surname>
<given-names><![CDATA[K]]></given-names>
</name>
<name>
<surname><![CDATA[Sakellaridis]]></surname>
<given-names><![CDATA[T]]></given-names>
</name>
<name>
<surname><![CDATA[Sikalias]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Karanikas]]></surname>
<given-names><![CDATA[I]]></given-names>
</name>
<name>
<surname><![CDATA[Economou]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Antsaklis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Subcutaneous emphysema, pneumomediastinum and pneumoperitoneum after unsuccessful ERCP:a case report]]></article-title>
<source><![CDATA[Cases J]]></source>
<year>2009</year>
<volume>2</volume>
<numero>1</numero>
<issue>1</issue>
<page-range>120</page-range></nlm-citation>
</ref>
<ref id="B7">
<label>7</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Fujii]]></surname>
<given-names><![CDATA[L]]></given-names>
</name>
<name>
<surname><![CDATA[Lau]]></surname>
<given-names><![CDATA[A]]></given-names>
</name>
<name>
<surname><![CDATA[Fleischer]]></surname>
<given-names><![CDATA[DE]]></given-names>
</name>
<name>
<surname><![CDATA[Harrison]]></surname>
<given-names><![CDATA[ME]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Successful nonsurgical treatment of pneumomediastinum, pneumothorax, pneumoperitoneum, pneumoretroperitoneum, and subcutaneous emphysema following ERCP]]></article-title>
<source><![CDATA[Gastroenterol Res Pract]]></source>
<year>2010</year>
<volume>2010</volume>
<page-range>289135</page-range></nlm-citation>
</ref>
<ref id="B8">
<label>8</label><nlm-citation citation-type="journal">
<person-group person-group-type="author">
<name>
<surname><![CDATA[Papamichail]]></surname>
<given-names><![CDATA[M]]></given-names>
</name>
<name>
<surname><![CDATA[Nikolaidis]]></surname>
<given-names><![CDATA[N]]></given-names>
</name>
<name>
<surname><![CDATA[Anastasiou]]></surname>
<given-names><![CDATA[E]]></given-names>
</name>
<name>
<surname><![CDATA[Sidirokastritis]]></surname>
<given-names><![CDATA[G]]></given-names>
</name>
<name>
<surname><![CDATA[Prigouris]]></surname>
<given-names><![CDATA[P]]></given-names>
</name>
</person-group>
<article-title xml:lang=""><![CDATA[Massive subcutaneus emphysema following endoscopic retrograde cholangiopancreatography with sphincterotomy]]></article-title>
<source><![CDATA[Case Rep Gastroenterol]]></source>
<year>2010</year>
<volume>4</volume>
<numero>3</numero>
<issue>3</issue>
<page-range>399-403</page-range></nlm-citation>
</ref>
</ref-list>
</back>
</article>
