Year 2023 / Volume 115 / Number 11
Letter
CT guided percutaneous drainage for left hepatic subcapsular hematoma after endoscopic retrograde cholangiopancreatography

655-656

DOI: 10.17235/reed.2023.9498/2023

Min Li, Kangning Yu, Denghao Deng, Jun Liu, Weiwei Chen, Juan Chen, Chaowu Chen,

Abstract
Endoscopic retrograde cholangiopancreatography has been widely used in the diagnosis and treatment of biliary and pancreatic diseases. Post-ERCP complications mainly include pancreatitis, infection, bleeding, and perforation. However, post-ERCP left hepatic subcapsular hematoma is a rare and potentially life-threatening complication. A total of five cases have been reported in the literature, including one death due to bleeding from a ruptured hematoma. We report a case of post-ERCP hepatic subcapsular hematoma of the left lobe of the liver in a 29-year-old woman who was diagnosed with a left hepatic subcapsular hematoma 56 hours after ERCP and whose symptoms did not improve after conservative treatment. A CT-guided percutaneous puncture was then performed, and the drainage fluid was a dark red fluid mixed with blood and bile. On days 1, 2, 3, 4, and 5, respectively, following drainage, the drainage flow was 400 ml, 40 ml, 70 ml, 50 ml, and 30 ml.
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References
[1] Montoya Rojo J O, Amezcua Gutiérrez M A, Castañón-González J A. Melena after endoscopic retrograde cholangiopancreatography: a warning sign of an impending subcapsular hepatic hematoma[J]. Medicina Clinica, 2020, 154(11): 467. DOI:10.1016/j.medcli.2019.04.014.
[2] Beristain-Hernández J L, Beristain-Silva J-L. Urgent left lobectomy as a treatment for broken and infected late subcapsular hepatic hematoma following endoscopic retrograde cholangiopancreatography[J]. Revista Espanola De Enfermedades Digestivas: Organo Oficial De La Sociedad Espanola De Patologia Digestiva, 2020, 112(9): 740–741. DOI:10.17235/reed.2020.6853/2019.
[3] Fernández-Gordón Sánchez Flor M.ª, Cudero Quintana L, Algara San Nicolás M, et al. Hepatic subcapsular hematoma post-endoscopic retrograde cholangiopancreatography requiring embolization[J/OL]. Revista Española de Enfermedades Digestivas, 2022[2023–02–04]. DOI:10.17235/reed.2022.9342/2022.
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Li M, Yu K, Deng D, Liu J, Chen W, Chen J, et all. CT guided percutaneous drainage for left hepatic subcapsular hematoma after endoscopic retrograde cholangiopancreatography. 9498/2023


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Publication history

Received: 29/01/2023

Accepted: 06/02/2023

Online First: 13/02/2023

Published: 13/11/2023

Article Online First time: 15 days

Article editing time: 288 days


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