Post–Endoscopic Retrograde Cholangiopancreatography (ERCP) Subcapsular Hepatic Hematoma

Abstract

Physicians need to recognize the potential complications of endoscopic retrograde cholangiopancreatography (ERCP), which are rare but can be serious. We describe a case of post-ERCP subcapsular hepatic hematoma (SHH). A 39-year-old man with a history of alcohol use, complicated by chronic pancreatitis and common bile duct (CBD) stricture, presented with right upper quadrant pain two weeks after the placement of a stent for CBD stricture. He was managed with pain control and antibiotics. SHH is a rare complication of ERCP. Hematomas can expand, resulting in significant anemia and liver function test (LFT) elevation, or can become infected. Patients with SHH must be carefully monitored in the post-ERCP setting.

Hepatic hematoma following endoscopic retrograde cholangiopancreatography: overview and case report

“…17 It can be concluded that patients who present hematoma rupture require some type of intervention, either by interventional radiology or surgery. 18 Roldan's group reported the case of a man who developed hepatic subcapsular hematoma after ERCP who presented with hemodynamic instability and computed tomography revealed a giant subcapsular hematoma requiring urgent surgery. 19 It is of utmost importance to take into account hepatic hematoma within the differential diagnosis of post-ERCP complications, especially when clinical data such as intense abdominal pain, hemodynamic instability, fever, decreased serum hemoglobin levels and typical characteristics in imaging studies are found.…”