Rare case of hepatic haematoma following endoscopic retrograde cholangiopancreatography

Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used diagnostic and therapeutic technique but it is not free of complications. Subcapsular hepatic haematoma is a rare but potentially fatal complication. A 71-years-old male patient resorted to the emergency department 36 hours aft...

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Bibliographic Details
Published in:BMJ case reports 2018-04, Vol.2018, p.bcr-2017-222638
Main Authors: Caroço, Teresa Vieira, Louro, João Mendes, Coelho, Maria Inês, Costa Almeida, Carlos Eduardo
Format: Article
Language:English
Subjects:
Abdomen
Abdominal Pain - diagnostic imaging
Abdominal Pain - etiology
Aged
Anticoagulants
Bile
Case reports
Cholangiopancreatography, Endoscopic Retrograde - adverse effects
Conservative Treatment
Disease prevention
Endoscopy
Gallstones
Hematoma - diagnostic imaging
Hematoma - etiology
Humans
Literature reviews
Liver Diseases - diagnostic imaging
Liver Diseases - etiology
Male
Medical imaging
Pain
Postoperative Complications - diagnostic imaging
Postoperative Complications - therapy
Treatment Outcome
Unexpected Outcome (Positive or Negative) Including Adverse Drug Reactions
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Summary:Endoscopic retrograde cholangiopancreatography (ERCP) is a commonly used diagnostic and therapeutic technique but it is not free of complications. Subcapsular hepatic haematoma is a rare but potentially fatal complication. A 71-years-old male patient resorted to the emergency department 36 hours after an uneventful ERCP presenting with severe abdominal pain and haemoglobin drop. Abdominal ultrasound and CT scan diagnosed a subcapsular hepatic haematoma. The patient was haemodynamically normal and was successfully treated with a conservative management. Signs and symptoms of hepatic haematoma following ERCP are non-specific. The most common symptom is abdominal pain. Abdominal CT, ultrasound or MRI make the diagnosis. Conservative management is possible if the patient is stable, nevertheless invasive treatment such as surgery or angiographic embolisation, may be required. A low threshold of suspicion is crucial for an early diagnosis and treatment. Fatal cases have been described but most patients have a favourable outcome.
ISSN:1757-790X
1757-790X
DOI:10.1136/bcr-2017-222638