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Montenovo, Martin I.; Javed, Emran; Bakthavatsalam, Ramasamy; Reyes, Jorgé

doi:10.6002/ect.2014.0234

Cited by 4 publications

(4 citation statements)

References 11 publications

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“…Selective splenic artery embolization was used in four cases (4/34). 11 , 18 , 26 , 27 Montenovo et al 26 used splenic artery embolization as a bridge therapy for splenectomy while Polman et al 18 used it as final treatment.…”

Section: Discussionmentioning

confidence: 99%

“…From all reviewed cases, many predisposing factors are referred to play an important role in post-ERCP splenic injury. These factors include altered anatomy from previous major surgeries such as left hepatectomy, 28 sleeve gastrectomy, 24 liver transplant, 26 Billroth I gastrectomy, 10 or other anatomic reasons such as cascade stomach 17 and small intra-abdominal cavity, 15 pancreatic head masses 8 , 13 and duodenal masses narrowing the duodenum lumen, pyloric stenosis, 8 , 22 , 29 and requirement of prolonged loop position to achieve cannulation. 25 The referred factors act by reducing the available space for endoscopic movements, increasing the duration of ERCP, multiplying the number of maneuvers needed for the proper cannulation, and increasing the direct forces transmitted to the surrounding tissues resulting in increased chances of a splenic injury.…”

Section: Discussionmentioning

confidence: 99%

“…Another risk factor could be the presence of adhesions due to previous abdominal surgeries. Adhesions 6 , 9 , 10 , 15 , 19 , 20 , 23 – 26 , 28 , 34 (12/34) decrease the mobility of abdominal organs and ligaments, making them more vulnerable to trauma. Patients’ general condition appears also to play a significant role.…”

Section: Discussionmentioning

confidence: 99%

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Endoscopic retrograde cholangiopancreatography induced splenic injury: comprehensive analysis and new perspectives based on a case report

Kourdakis,

Deftereos

2024

Clin Med Insights Gastroenterol

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Splenic injury is an extremely rare complication of endoscopic retrograde cholangiopancreatography (ERCP). There are only 34 cases reported in the literature up to now. Based on a case of a 72-year-old man, who after ERCP due to choledocholithiasis developed a large perisplenic and subcapsular hematoma, we carried out an extensive review of all cases of ERCP-induced splenic injury found in the literature. We searched PubMed/Medline and Google Scholar till 15 April 2023, for published case reports and series using the following terms: splenic injury after ERCP, ERCP-induced splenic injury, and post-ERCP splenic trauma. The case reports included were in English, Spanish, and German literature. We attempt to discuss the possible clinical image, the available diagnostic methods, the potential treatment alternatives, and predisposing factors related to this entity. Furthermore, a theory of a possible mechanism of this injury is discussed and supported schematically. The ERCP-induced splenic injury is rare and a high index of suspicion is needed for diagnosis. Therefore, we present two diagnostic algorithms, which according to our opinion may assist the evaluation of this complication and lead to early accurate diagnosis and appropriate management. Collectively, our findings support that although ERCP-induced splenic injury is an unexpected/unusual complication of ERCP, following the proper steps can be timely diagnosed and treated.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Endoscopic retrograde cholangiopancreatography induced splenic injury: comprehensive analysis and new perspectives based on a case report

Kourdakis,

Deftereos

2024

Clin Med Insights Gastroenterol

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“…There are many accounts of splenic injury after colonoscopy and are well described in the literature, but splenic injury after ERCP is much less frequent. Splenic injury can include subcapsular hematoma 5 6 , peri-splenic hematoma 6 , laceration 6 7 , rupture 6 8 , avulsion of splenic vessels 6 9 , avulsion of spleen from the capsule 6 10 , and direct tearing of the splenic capsule 6 8 . The main factors influencing complication rate were the difficulty of the examination, patient comorbidity, and the operator’s level of experience 1 6 .…”

Section: Introductionmentioning

confidence: 99%

Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

Pamudurthy¹,

Abraham²,

Betlej³

et al. 2018

Endosc Int Open

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Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.

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Splenic subcapsular hematoma following endoscopic retrograde cholangiopancreatography: A case report and review of literature

Guo,

Wei

2024

World J Clin Cases

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BACKGROUND Splenic injury following endoscopic retrograde cholangiopancreatography (ERCP) is a rare complication. The literature contains around 30 articles reporting various degrees of splenic injuries resulting from ERCP since the first report of splenic rupture after ERCP in 1989. CASE SUMMARY This report describes a case of splenic hematoma and stent displacement in a 69-year-old male patient who developed these conditions 7 days after undergoing ERCP and stenting. The patient had bile duct stenosis caused by a malignant tumor that was obstructing the bile duct. The diagnosis was confirmed by epigastric computed tomography and magnetic resonance cholangiopancreatography. The patient was successfully treated with percutaneous transhepatic cholangial drainage, endoscopic pyloric stent placement, and conservative management. The causes of splenic injury following ERCP are discussed. CONCLUSION ERCP has the potential to cause splenic injury. If a patient experiences symptoms such as abdominal pain, decreased blood pressure, and altered hematology after the procedure, it's important to be thoroughly investigated for postoperative bleeding and splenic injury.

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Abstract: Splenic injuries after an endoscopic retrograde cholangiopancreatography are a rare but lethal complication. We describe a subcapsular splenic hematoma requiring emergent splenectomy after an endoscopic retrograde cholangiopancreatography in a liver transplant recipient.

Cited by 4 publications

References 11 publications

Endoscopic retrograde cholangiopancreatography induced splenic injury: comprehensive analysis and new perspectives based on a case report

Endoscopic retrograde cholangiopancreatography induced splenic injury: comprehensive analysis and new perspectives based on a case report

Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

Splenic subcapsular hematoma following endoscopic retrograde cholangiopancreatography: A case report and review of literature

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