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CASE REPORT
Rare case of hepatic haematoma following endoscopic retrograde cholangiopancreatography
  1. Teresa Vieira Caroço1,2,
  2. João Mendes Louro1,
  3. Maria Inês Coelho1,
  4. Carlos Eduardo Costa Almeida1
  1. 1Cirurgia C, Hospital Geral (Covões) - Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
  2. 2Serviço de Cirurgia Geral, Instituto Português de Oncologia de Coimbra Francisco Gentil E.P.E, Coimbra, Portugal
  1. Correspondence to Dr Teresa Vieira Caroço, tvieiracaroco{at}gmail.com

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.

  • biliary intervention
  • endoscopy
  • pancreas and biliary tract
  • general surgery
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Footnotes

  • Contributors TC: manuscript writing, manuscript review, data collection. JML: manuscript review, data collection. MICMC: manuscript review. CCA: manuscript review.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Patient consent Obtained.

  • Provenance and peer review Not commissioned; externally peer reviewed.

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