Tumors of the ampulla of Vater represent about 5 % of gastrointestinal neoplasms and are more often identified during upper gastrointestinal endoscopy [1], most are adenomas forming part of the adenoma–carcinoma sequence [2]. The first endoscopic resection of a duodenal adenoma was performed in the 1970 s [3], since when this procedure has become increasingly common, and the management has shifted from surgical resection to endoscopic procedures [1] [2] [3] [4]. We present here the first report in the literature in English, of a major septic complication after endoscopic ampullectomy.