CC BY-NC-ND 4.0 · Endosc Int Open 2018; 06(03): E271-E273
DOI: 10.1055/s-0043-125145
Case report
Owner and Copyright © Georg Thieme Verlag KG 2018

Etiologies and risks of splenic decapsulation after endoscopic retrograde cholangiopancreatography: case report and literature review

Vijeta Pamudurthy
Department of Medicine, Riverside Medical Center, Kankakee, Illinois United States
,
Raju Z. Abraham
Department of Medicine, Section of Pulmonology/Critical Care, Riverside Medical Center, Kankakee, Illinois, United States
,
Thomas Betlej
Department of Pathology, Riverside Medical Center, Kankakee, Illinois, United States
,
Ashish Shah
Department of Medicine, Section of Gastroenterology, Riverside Medical Center, Kankakee, Illinois, United States
,
Dong Kim
Department of General Surgery, Riverside Medical Center, Kankakee, Illinois, United States
,
Brian Sasso
Department of Medicine, Section of Gastroenterology, Riverside Medical Center, Kankakee, Illinois, United States
,
Abraham Chacko
Department of Medicine, Section of Gastroenterology, Riverside Medical Center, Kankakee, Illinois, United States
› Author Affiliations
Further Information

Publication History

submitted 06 September 2017

accepted after revision 15 November 2017

Publication Date:
28 February 2018 (online)

Abstract

Background and study aims Endoscopic retrograde cholangiopancreatography (ERCP) is an invasive diagnostic and interventional procedure used in conditions related to the pancreas and biliary tract. It has a complication rate ranging from 4 % to 10 %. Severe complications are few with the most common of them being post-ERCP pancreatitis, post-sphincterotomy bleeding, and perforation. A rare, but potentially life-threatening complication of ERCP is splenic injury. We report the case of a 60-year-old female with choledocholithiasis who sustained splenic decapsulation following ERCP. The exact causes of splenic injury are unknown, although several mechanisms are postulated. A literature review of splenic injuries post-ERCP shows that there are only 3 cases with post-ERCP splenic decapsulation. Our patient is the first one in whom splenic decapsulation occurred without any risk factors or technical difficulties during the procedure. A high index of suspicion for splenic injury is required in any patient who has severe pain, anemia, or hemorrhagic shock after ERCP.