Subcapsular hepatic hematoma following ERCP: case report and review

Pozo, David; Moral, I.; Poves, Elvira; Sanz, Clara; Martin, Michael R.

doi:10.1055/s-0030-1256267

Cited by 28 publications

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“…In such cases, we recommend the use of prophylactic antibiotics, given the risk of infected hematoma. 17 Surgical treatment should be taken into account in case of deterioration of general clinical conditions, hemodynamic instability, infected hematoma, or high risk of hematoma breakage. 17 This treatment consists in draining hematoma, hemostasis if possible, and follow-up by CT, in order to monitor progress.…”

Section: Discussionmentioning

confidence: 99%

“… 17 Surgical treatment should be taken into account in case of deterioration of general clinical conditions, hemodynamic instability, infected hematoma, or high risk of hematoma breakage. 17 This treatment consists in draining hematoma, hemostasis if possible, and follow-up by CT, in order to monitor progress. 19 A viable alternative to surgical treatment is represented by selective or superselective embolization of involved vessels or percutaneous drainage of hematoma.…”

Section: Discussionmentioning

confidence: 99%

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Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

et al. 2015

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Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently performed procedures for the diagnosis and treatment of biliary-pancreatic diseases. ERCP-related complications total around 2.5% to 8%, with a mortality rate ranging from 0.5% to 1%. An exceptional ERCP complication is subcapsular hepatic hematoma, and few cases are reported worldwide.We present the case of a 52-year-old woman with a history of recurring upper abdominal pain and a clinical and ultrasonographic diagnosis of obstructive jaundice due to common bile duct stones. After 2 difficult endoscopic biliary procedures, common bile duct stones clearance was obtained. Post-ERCP course was symptomatic with upper abdominal pain and anemization with hemodynamic instability.CT scan demonstrated a 15 cm × 11 cm subcapsular hepatic hematoma filled with air and liquid on the surface of the right hepatic lobe. The patient was successfully treated with the embolization of a small branch of right hepatic artery angiographically identified as the cause of bleeding.Subcapsular hepatic hematoma after ERCP is a rare complication that must be taken into account in the differential diagnosis of symptomatic cases after ERCP. Its diagnosis is based on clinical and laboratory data and especially on imaging (ultrasound, CT, or MRI). Treatment is often conservative but, in some cases, embolization or percutaneous drainage or surgery may be necessary.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

et al. 2015

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“…This should be the treatment of choice provided the patient remains hemodinamically stable [10]. However, based on the literature, we recommend that prophylactic antibiotics be administered, since there is a substantial risk of infection of the hematoma [11], and in the majority of cases, patients were treated with antibiotics ( Table 1).…”

Section: Discussionmentioning

confidence: 99%

“…Surgical treatment is reserved for patients with signs of hemodynamic instability or infection, or in cases of high risk of hematoma rupture or its growth [11]. It should consist of drainage of the hematoma, hemostasis if possible, and performing CT to monitor its evolution.…”

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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“…Antibiotic prophylaxis is recommended because of the risk for infected hematoma. 10 Surgical management should be considered when the general condition of the patient deteriorates and in case of the presence of hemodynamic instability, free fluid in the abdomen and peritoneal irritation. Percutaneous drainage should be considered as alternative to surgery.…”

Section: Discussionmentioning

confidence: 99%

Subcapsular Hepatic Hematoma Following Endoscopic Retrograde Cholangiopancreatography

Sakin¹,

Erdal²

2020

Turkiye Klinikleri J Case Rep

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Subcapsular hepatic hematoma following ERCP: case report and review

Cited by 28 publications

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Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

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

Subcapsular Hepatic Hematoma Following Endoscopic Retrograde Cholangiopancreatography

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