Abstract
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 ultrasound-guided 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.
Highlights
Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used procedure that has revolutionized the management of biliopancreatic diseases
Hepatic subcapsular hematoma (HSH) is an uncommon complication of endoscopic retrograde cholangiopancreatography (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
Summary
Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used procedure that has revolutionized the management of biliopancreatic diseases. A computed tomography (CT) scan of the abdomen was performed with CT angiography, which revealed a large heterogeneous lesion (12.3 × 5.2 × 13.7 cm) with air foci within the subcapsular region of the right hepatic lobe, indicating a large HSH (Figure 1). How to cite this article Arya R, Priyadarshi R N, Maji T, et al (February 05, 2022) Large Hepatic Subcapsular Hematoma Following Endoscopic Retrograde Cholangiopancreatography: A Case Report. Her hemoglobin levels remained rather stable, she developed fever along with a cough. Her CT thorax revealed consolidation involving the right lower lobe, suggesting lobar pneumonia, and the lower cuts of her chest CT revealed further expansion of hematoma. A CT scan done six weeks later showed near-complete resolution of HSH (Figure 4)
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