El Koubayati G, Charbel T, Aoun A, Choueiry R. Hepatic subcapsular hematoma: A rare complication post-ERCP; a case report.
Medicine (Baltimore) 2024;
103:e37705. [PMID:
38552039 PMCID:
PMC10977585 DOI:
10.1097/md.0000000000037705]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/16/2023] [Accepted: 03/04/2024] [Indexed: 04/02/2024] Open
Abstract
INTRODUCTION
Endoscopic retrograde cholangiopancreatography (ERCP) is commonly used in gastroenterology wards for both diagnostic and therapeutic purposes. It doesn't however come free of complications. As a matter of fact, complications are reported in up to 10% of patients undergoing ERCP.
PATIENT CONCERNS
In this article, we report the case of a patient who underwent ERCP and sphincterotomy for choledocholithiasis. Twenty-four hours after the procedure, the patient developed sudden sharp abdominal pain and dropped her hemoglobin levels.
DIAGNOSIS
An emergent gastroscopy was done and it ruled out bleeding from the sphincterotomy. Computed tomography of the abdomen showed a large hepatic subcapsular hematoma.
INTERVENTIONS
Blood was urgently transfused and the patient was transferred to the intensive care unit for monitoring.
OUTCOMES
The patient's condition quickly deteriorated despite extensive resuscitative measures, and eventually passed away on day 4 post ERCP.
LESSONS
Hepatic subcapsular hematoma is a very rare but fatal complication after ERCP and should be ruled out in patients who underwent the procedure and develop sudden abdominal pain with hemodynamic and laboratory instability.
Collapse