Published online May 7, 2016. doi: 10.3748/wjg.v22.i17.4411
Peer-review started: December 11, 2015
First decision: January 13, 2016
Revised: January 26, 2016
Accepted: February 22, 2016
Article in press: February 22, 2016
Published online: May 7, 2016
Sub capsular hepatic haematoma is a rare complication after endoscopic retrograde cholangiopancreatography (ERCP). Exact pathological mechanism is still unclear and few reports are nowadays available in literature. We report the case of a 58-year-old woman with recurrent episodes of upper abdominal pain, nausea and vomiting. On the basis of laboratory exams, abdomen ultrasound and magnetic resonance imaging she was diagnosed with a common bile duct stone. Endoscopic biliary sphincterotomy was performed. On the following day the patient complaint severe abdominal pain with rebound and hemodynamic instability. A computed tomography scan reveal a 14 cm × 6 cm × 19 cm sub-capsular hepatic haematoma on the right lobe that was successfully managed via percutaneous embolization. Sub capsular liver haematoma is a rare life threatening complication after ERCP that should be managed according to patients’ haemodynamic and clinic.
Core tip: Hepatic hematoma is a rare and potentially life threatening complication after endoscopic retrograde cholangiopancreatography (ERCP). Despite its severity, only few cases are described in current literature. The paper describe the management of a huge right lobe hepatic hematoma following ERCP. An exhaustive literature analysis is made considering, signs and symptoms at presentation, time of presentation, diagnosis, and treatment. Awareness of this potential complication, high level of suspicion and prompt treatment are at the basis of better outcomes in such patients.