Subcapsular hepatic hematoma post ERCP: a rare or an underdiagnosed complication?

Endoscopic retrograde cholangiopancreatography (ERCP) is a minimally invasive procedure for diagnosis and treatment of biliary and pancreatic disease that even in expert hands can have complications in 2 % – 10 % of cases, with mortality rates of 0.5 % – 1 % [1] [2]. Pancreatitis, cholangitis, perforation, and bleeding from papillotomy have been the most frequently described complications.

Subcapsular hepatic hematoma is a rare complication following ERCP. The first report was in 2001 by Ortega et al. [1], and since then only a few cases have been described worldwide. We present a series of three cases of subcapsular hepatic hematoma post ERCP, treated at our institution in a 5-year period.

• References

• 1 Ortega Deballon P, Fernández Lobato R, García Septiem J et al. Liver hematoma following endoscopic retrograde cholangiopancreatography (ERCP). Surg Endosc 2000; 14: 767
• 2 Hart R, Classen M. Complications of diagnostic gastrointestinal endoscopy. Endoscopy 1990; 22: 229-233
• 3 Horn TL, Pena LR. Subcapsular hepatic hematoma after ERCP: case report and review. Gastrointest Endosc 2004; 59: 594-596
• 4 Ertuğrul I, Parlak E, Ibiş M et al. An unusual complication of endoscopic retrograde cholangiopancreatography. Dig Dis Sci 2006; 51: 1167-1168
• 5 Petit-Laurent F, Scalone O, Penigaud M et al. Sub-capsular hepatic hematoma after ERCP: case report and literature review. Gastroenterol Clin Biol 2007; 31: 750-752
• 6 De La Serna-Higuera C, Fuentes A, Rodríguez S. Hematoma hepático subcapsular secundario al empleo de una guía hidrofílica durante una colangio-pancreatografía retrógrada endoscópica. Gastroenterol Hepatol 2008; 31: 264-267
• 7 Priego P, Rodríguez G, Mena A et al. Hematoma sub-capsular hepático tras CPRE. Rev Esp Enf Ap Dig 2007; 99: 53-54
• 8 Nari G, Preciado J, Rosendo N. A rare complication of ERCP: sub-capsular liver haematoma. Cir Esp 2009; 85: 253-263
• 9 Chi KD, Waxman I. Sub-capsular hepatic hematoma after guide-wire injury during endoscopic retrograde cholangiopancreatography: management and review. Endoscopy 2004; 36: 1019-1021
• 10 Bhati CS, Inston N, Wigmore SJ. Subcapsular intrahepatic hematoma: an unusual complication of ERCP. Endoscopy 2007; 39: E150