Case Report
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World J Gastroenterol. Mar 7, 2013; 19(9): 1502-1504
Published online Mar 7, 2013. doi: 10.3748/wjg.v19.i9.1502
Subcapsular hepatic haematoma after endoscopic retrograde cholangiopancrea-tography: An unusual case
Bao-Ying Fei, Cai-Hong Li
Bao-Ying Fei, Cai-Hong Li, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China
Author contributions: Fei BY contributed to the manuscript writing and revision; Li CH took part in the research.
Correspondence to: Bao-Ying Fei, PhD, Professor, Department of Gastroenterology, Zhejiang Provincial People’s Hospital, Hangzhou 310014, Zhejiang Province, China. feibaoying@hotmail.com
Telephone: +86-571-85893430 Fax: +86-571-85131448
Received: November 22, 2012
Revised: December 16, 2012
Accepted: January 18, 2013
Published online: March 7, 2013
Processing time: 109 Days and 17.5 Hours
Abstract

Subcapsular hepatic haematoma is a rare complication of endoscopic retrograde cholangiopancrea-tography (ERCP), and there are few reports about this unusual complication worldwide. The primary symptom of most cases reported in the literature is abdominal pain. We report an unusual case with the primary symptom of fever. A 56-year-old man who had a six-month history of recurrent episodes of upper abdominal pain was diagnosed with a common bile duct stone by magnetic resonance cholangiopancrea-tography. Endoscopic biliary sphincterotomy was performed, and stones from the common bile duct were successfully extracted with a basket. The patient had a persistent fever after ERCP, and treatment with intravenous antibiotics was unsuccessful. Computed tomography showed a 13 cm × 6 cm subcapsular hepatic haematoma filled with air and liquid on the surface of the right hepatic lobe. The patient was successfully treated with peritoneal drainage under B-ultra guidance. Subcapsular liver haematoma should be considered when hard-to- explain symptoms persist in the early period after ERCP. Percutaneous drainage is an effective treatment.

Keywords: Endoscopic retrograde cholangiopancrea-tography; Hepatic; Hematoma; Complication; Treatment