Rectal Indomethacin vs Intravenous Ketorolac

Exclusion Criteria

• •\< 10 kg
• •Low risk subgroup: Biliary indication with history of prior biliary sphincterotomy.
• •High risk for bleeding (Example: Planned liver biopsy)
• •Gastrointestinal bleeding in previous 3 days
• •Acute pancreatitis (within 3 days) at the time of ERCP
• •Use of NSAIDs in the previous 5 days
• •Peptic ulcer disease
• •Acute kidney Injury or Known Chronic Kidney Disease per KDIGO
• •Pregnancy (Pregnancy tests are administered prior to ERCP as standard of care)
• •Lithium therapy
• •Allergy to ketorolac or indomethacin
• •Organ Dysfunction or SIRS