Difficult Biliary Cannulation

Lynch, S.; Evans, John A.

doi:10.1007/s11894-010-0089-0

Cited by 7 publications

(5 citation statements)

References 34 publications

(28 reference statements)

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“…In most cases, however, hematoma occured as the result of a rupture of a small calibre intrahepatic vessel caused by a guide wire. This would also explain the presence of air inside the hematoma and frequent infections, as use of guide wire is not a sterile technique [6]. In one case, the hematoma was a consequence of a traction of the extracting balloon in order to withdraw it from the biliary tree [7].…”

Section: Discussionmentioning

confidence: 99%

Subcapsular Hepatic Hematoma after ERCP: A Case Report and Revision of Literature

Klimova¹,

Suárez²,

Asanza³

et al. 2014

CRCM

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Introduction: Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive procedure for diagnosis and treatment of biliary and pancreatic diseases. Even in the best hands, complications may occur. Clinically significant hemorrhagic complications associated usually to previous papillotomy are uncommon. Subcapsular hepatic hematoma is excepcional, with only twenty cases described. We present a case of a 52-year-old man who developed a large subcapsular liver hematoma following a therapeutic ERCP. Due to serious anemization and hemodynamic instability, arterial embolization and finally urgent surgical evacuation of the hematoma were performed. In the postoperative period the patient presented infection of the collection, which indicated colocation of percutaneous drainage and broad-spectrum intravenous antibiotics, and gradually recovered.

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Section: Discussionmentioning

confidence: 99%

Subcapsular Hepatic Hematoma after ERCP: A Case Report and Revision of Literature

Klimova¹,

Suárez²,

Asanza³

et al. 2014

CRCM

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“…One cause could be accidental biliary tree vascular injury from the guide wire used in the procedure leading to hemorrhage. [11] Another theory suggests that during biliary clearance using a balloon, tractional pressures develop leading to rupture of small biliary blood vessels, resulting in intraparenchymal hemorrhage and subcapsular collection due to centrifugal flow of blood. [7] In our case, HSH was diagnosed 1 day after ERCP but it may take up to 10 days to be diagnosed.…”

Section: Discussionmentioning

confidence: 99%

Hepatic subcapsular hematoma: A rare complication post-ERCP; a case report

El Koubayati,

Charbel,

Aoun

et al. 2024

Medicine

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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.

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“…One theory proposes that during biliary clearance using a balloon, tractional pressures develop, causing small biliary blood vessels to rupture, resulting in intraparenchymal hemorrhage and subcapsular collection due to centrifugal flow of blood [ 5 ]. According to another theory, the guidewire used in ERCP might cause injury to small caliber vessels in the biliary tree, resulting in injury and hemorrhage [ 7 ]. This mechanism would also justify the presence of air in the hematoma.…”

Section: Discussionmentioning

confidence: 99%

Large Hepatic Subcapsular Hematoma Following Endoscopic Retrograde Cholangiopancreatography: A Case Report

Arya¹,

Priyadarshi²,

Maji³

et al. 2022

Cureus

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For decades, endoscopic retrograde cholangiopancreatography (ERCP) has been the cornerstone in the treatment of several biliopancreatic diseases. Although it is a relatively safe procedure, there are certain hazards involved. Hepatic subcapsular hematoma (HSH) is an uncommon complication of ERCP, with only a few cases reported in the literature to date. We present here a case of large HSH that developed 48 hours after an otherwise uneventful ERCP for choledocholithiasis. After being apparently well for the first two days post-ERCP, the patient began to develop abdominal pain and restlessness associated with hemodynamic instability and a decline in hemoglobin levels. Computed tomography (CT) confirmed the presence of a large HSH. The patient was managed nonsurgically with vascular angioembolization followed by ultrasoundguided percutaneous catheter drainage of hematoma. This case highlights the necessity of increasing awareness about this complication in order to aid in early diagnosis and management.

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Difficult Biliary Cannulation

Cited by 7 publications

References 34 publications

Subcapsular Hepatic Hematoma after ERCP: A Case Report and Revision of Literature

Subcapsular Hepatic Hematoma after ERCP: A Case Report and Revision of Literature

Hepatic subcapsular hematoma: A rare complication post-ERCP; a case report

Large Hepatic Subcapsular Hematoma Following Endoscopic Retrograde Cholangiopancreatography: A Case Report

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