Introduction:

Endoscopic retrograde colangiopancreatography (ERCP) is an effective diagnostic-therapeutic procedure, associated to several complications.

Objective:

To describe a case report presenting two concomitant post-ERCP complications.

Methods:

A 65-year-old male presented with a previous history of cholecystectomy, common bile duct (CBD) exploration and T-tube placement, in whom was performed ERCP with difficult cannulation, Rendezvous technique and CBD stone extraction with balloon, presenting acute abdomen.

Results:

Findings of laparotomy included pancreatic necrosis. During his evolution he developed a pancreatic fistula with positive evolution and hospital discharge.

Conclusions:

Severe complications may present concomitantly despite preventive measures.