Table 1 Classification of duodenal perforations according to Stapfer et al. (Ref. 8)

I

Endoscope-related lateral or medial duodenal wall perforations

Often large and distant from the ampulla, requires surgical intervention in most cases

II

Retroperitoneal peri-Vaterian perforations resulting from (pre-cut) sphincterotomy

Of variable severity but most often discrete and amenable to conservative management

III

Distal common bile duct injuries secondary to guidewire insertion or instrumentation for stone extraction

Amenable to conservative management

IV

Isolated retroperitoneal air from excessive insufflation

Does not require specific treatment