“…Some therapeutic additional options, especially sphincterotomy, increase the risk of intestinal perforation [ 4 ]. Iatrogenic post-ERCP duodenal perforation is regarded as a common complication, while intrahepatic bile duct ruptures are rare and have been associated in case reports with surgically damaged liver tissue, liver metastasis, and abscesses [ 5 , 6 ]. In our case report, the radiologist found the biliary peritonitis to be a consequence of duodenal perforation; however, the surgical team intraoperatively identified a ruptured, but otherwise, healthy subcapsular hepatic bile duct as the cause of the biliary peritonitis.…”