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Subcapsular Hepatic Hematoma Post-ERCP: Case Report and Review of the Literature

  • C. Sommariva
  • A. LauroEmail author
  • N. Pagano
  • S. Vaccari
  • V. D’Andrea
  • I. R. Marino
  • M. Cervellera
  • V. Tonini
DDS–SIRC COOPERATIVE CONFERENCES
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Abstract

Introduction

Hepatic hematoma is a rare but possible complication of ERCP. We describe the case of a 75-year old man with a large, 8 × 12 cm, sub-capsular and intra-parenchymal hematoma post ERCP, affecting the right liver segments and treated conservatively.

Areas covered

A review of literature has been performed, highlighting two possible mechanisms: hematoma may occur as the result of accidental laceration of a small intrahepatic vessel by the guidewire, whereas the other hypothesis posits that the hepatic damage is secondary to traction on the biliary system exerted by the balloon. We speculate that in case of anomalies of the biliary tree, the incidence of this complication is higher than expected.

Expert commentary

In case of hepatic hematoma post ERCP, a conservative approach should always be considered before proceeding to interventional radiologic procedures or to surgical therapy.

Keywords

Hepatic hematoma ERCP Abdominal pain Endoscopic procedure Pancreatitis 

Abbreviations

EKG

Electrocardiogram

AST

Aspartate aminotransferase

ALT

Alanine aminotransferase

NG tube

Nasogastric tube

CT

Computed tomography scan

ERCP

Endoscopic retrograde cholangiopancreatography

EGD

Esophagogastro-duodenal endoscopy

Hgb

Hemoglobin

US

Ultrasound

PM

Pacemaker

IV

Intravenous

GI

Gastrointestinal

Notes

Compliance with Ethical Standards

Conflict of interest

None of the authors have any conflicts of interest pertaining to this work.

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • C. Sommariva
    • 1
  • A. Lauro
    • 1
    Email author
  • N. Pagano
    • 1
  • S. Vaccari
    • 1
  • V. D’Andrea
    • 2
  • I. R. Marino
    • 3
  • M. Cervellera
    • 1
  • V. Tonini
    • 1
  1. 1.Surgery Emergency and GI DepartmentSt. Orsola University HospitalBolognaItaly
  2. 2.Department of Surgical SciencesLa Sapienza University, Umberto I HospitalRomeItaly
  3. 3.Sidney Kimmel Medical CollegeThomas Jefferson UniversityPhiladelphiaUSA

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