Hepatic hematoma after ERCP: two new case reports

Martínez, María del Moral; Maroto, Ana Delgado; Tejada, María Eloísa Cervilla Sáez de; Caballero, Francisco Javier Casado; Escobar, Francisco Javier Salmerón

doi:10.17235/reed.2017.4237/2016

Cited by 12 publications

(12 citation statements)

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“…In these cases, most patients survived and only three patients deceased [6][7][8][9][10]. Although the mortality rate of complication could be low, it is still potentially lifethreatening.…”

Section: Discussionmentioning

confidence: 99%

A potential complication following endoscopic retrograde cholangiopancreatography: Subcapsular hepatic hematoma

Yang¹,

Chen²,

Huang³

2018

biomedicalresearch

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Endoscopic Retrograde Cholangiopancreatography (ERCP) is a technique with high success rate for diagnosis and treatment of biliary and pancreatic diseases, but haemorrhagic complications usually occurs when utilizing Endoscopic Sphincterotomy (EST) or Endoscopic Papillotomy (EPT). Here, we described the case of a 37-y-old female whose Common Bile Duct (CBD) stones were removed via ERCP and EPT due to dilated gallbladder and CBD obstruction. However, the patient suffered from subcapsular hepatic hematoma, sepsis, acute pancreatitis after ERCP. We arranged a second ERCP, Endoscopic Naso-Biliary Drainage (ENBD) and removed stones from gallbladder and junction of CBD and Common Hepatic Duct (CHD) by the Laparoscopic Common Bile Duct Exploration (LCBDE), as well as long-term antibiotic treatment. The patient then had a good condition of postoperative recovery. Hence, it should be alarming that subcapsular hepatic hematoma could be a potential complication post-ERCP and is life-threatening, and we provided the experience of utilizing a number of diagnostic techniques and a multidisciplinary approach of therapy strategies for resolving such complication successfully.

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Section: Discussionmentioning

confidence: 99%

A potential complication following endoscopic retrograde cholangiopancreatography: Subcapsular hepatic hematoma

Yang¹,

Chen²,

Huang³

2018

biomedicalresearch

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“…11 It is important to mention that early clinical presentation has been reported within the first 72 hours, and late after 7 days following ERCP; therefore, we conclude that it is not a complication following ERCP only of early presentation, and high clinical suspicion should be held in any patient regardless of the time of evolution. 12 Fernandez et al have reported a case of hepatic subcapsular hematoma as an incidental finding during laparoscopic cholecystectomy in a patient who had previously undergone ERCP for choledochal lithiasis, which shows that this pathology may be underdiagnosed. Abdominal computed tomography (CT) and magnetic resonance imaging (MRI) are useful; however, CT is the imaging method of choice, being able to characterize the lesion, define size, location and specific characteristics.…”

Section: Discussionmentioning

confidence: 99%

Hepatic hematoma following endoscopic retrograde cholangiopancreatography: overview and case report

et al. 2023

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Endoscopic retrograde cholangiopancreatography (ERCP) is a procedure with a high risk of complications. Hepatic subcapsular hematoma is an infrequent complication, with few cases reported in the international literature. Treatment can be conservative with the patient under close surveillance in an intensive care unit and surgical management is reserved for failure of conservative treatment and cases with hemodynamic instability. We present a case of subcapsular and intraparenchymal hepatic hematoma in an adult male who presented sudden hemodynamic instability, associated with hemoglobin decrease, which required surgical management. The challenge in the therapeutic decision due to sudden hemodynamic instability is clearly demonstrated; therefore, there was a need for surgical treatment as the best measure of hemorrhage control. Conservative management should be reserved for hemodynamically stable patients and invasive management by interventional radiology or surgery for cases of acute abdomen associated with hemodynamic instability.

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“…Second one, has greater logic due to the fact that so much pressure can be generated in the extraction, that the hepatic capsule and biliary complex when taken as a whole, can transmit the raw force of the operator. 4 Being a rare complication from the ERCP doesn't mean not to be energic treated or attended. Whatever the reason, the endoscopist should know, ERCP complications can be so complex to manage that even for a minimal procedure, and the patient can be admitted to intensive care.…”

Section: Discussionmentioning

confidence: 99%