Rectal Indomethacin vs Intravenous Ketorolac

Inclusion Criteria: * Any patient undergoing ERCP (diagnostic or therapeutic with cannulation of the major or minor papilla) * Age 6 month- 21 years old * Does not meet exclusion criteria 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