Una rara complicación de la CPRE: el hematoma subcapsular hepático

Nari, Gustavo; Vargas, Jacqueline Preciado; Ballesteros, Noreen Rosendo

doi:10.1016/j.ciresp.2008.04.002

Cited by 14 publications

(2 citation statements)

References 6 publications

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“…Its diagnosis is based on clinical data (abdominal pain, anemia, hypotension, and fever), laboratory data (decrease in hematocrit and hemoglobin levels), and especially on imaging (ultrasound, CT, or magnetic resonance imaging). 7 , 13 Treatment is often conservative but, in some cases, embolization or percutaneous drainage or surgery turn out to be necessary.…”

Section: Discussionmentioning

confidence: 99%

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%

Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

et al. 2015

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“…HSH is confirmed by imaging modalities such as abdominal US or CT scan. [10,[13][14][15] Treatment is mainly conservative for persistently stable patients, with prophylactic antibiotics recommended given the risk of infected hematoma. [16,17] Unstable patients with ruptured HSH or peritonitis should undergo surgical treatment.…”

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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Subcapsular Hepatic Hematoma Post-ERCP: Case Report and Review of the Literature

Sommariva¹,

Lauro²,

Pagano³

et al. 2019

Dig Dis Sci

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Introduction Hepatic hematoma is a rare but possible complication of ERCP. We describe the case of a 75-year old man with a large, 8 × 12 cm, sub-capsular and intra-parenchymal hematoma post ERCP, affecting the right liver segments and treated conservatively. Areas covered A review of literature has been performed, highlighting two possible mechanisms: hematoma may occur as the result of accidental laceration of a small intrahepatic vessel by the guidewire, whereas the other hypothesis posits that the hepatic damage is secondary to traction on the biliary system exerted by the balloon. We speculate that in case of anomalies of the biliary tree, the incidence of this complication is higher than expected. Expert commentary In case of hepatic hematoma post ERCP, a conservative approach should always be considered before proceeding to interventional radiologic procedures or to surgical therapy.

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Una rara complicación de la CPRE: el hematoma subcapsular hepático

Cited by 14 publications

References 6 publications

Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

Subcapsular Hepatic Hematoma After Endoscopic Retrograde Cholangiopancreatography

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

Subcapsular Hepatic Hematoma Post-ERCP: Case Report and Review of the Literature

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