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Liver hematoma following endoscopic retrograde cholangiopancreatography (ERCP)

P Ortega Deballon1, R Fernández Lobato, J García Septiem

  • 1Department of Surgery, Hospital Universitario de Getafe (Madrid), Ctra. de Toledo Km. 12,500, 28905 Getafe, Spain.

Surgical Endoscopy
|April 5, 2001
PubMed

Insights

An 81-year-old man developed an infected hematoma after endoscopic retrograde cholangiopancreatography (ERCP). This rare iatrogenic injury, potentially caused by guide wire trauma, required CT-guided drainage and catheterization.

Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Surgical Complications

Background:

  • Endoscopic retrograde cholangiopancreatography (ERCP) is a common procedure for diagnosing and treating biliary and pancreatic duct diseases.
  • Choledocholithiasis, gallstones in the common bile duct, is a frequent indication for ERCP.
  • While generally safe, ERCP carries potential risks and complications, including iatrogenic injuries.

Observation:

  • An 81-year-old male patient experienced abdominal pain post-ERCP for choledocholithiasis.
  • Imaging revealed an infected hematoma.
  • The hematoma was successfully treated with CT-guided puncture and drainage, with a catheter placed for 3 weeks.

Findings:

  • Cultures from the drained fluid identified Citrobacter freundii, confirming an infected hematoma.
  • The authors hypothesize the injury resulted from hepatic parenchyma tearing by the ERCP guide wire.
  • This represents the first reported case of this specific iatrogenic complication following ERCP.

Implications:

  • Highlights a rare but serious iatrogenic complication of ERCP.
  • Emphasizes the importance of vigilance for unusual presentations post-procedure.
  • Suggests potential technical modifications during ERCP to minimize guide wire-induced hepatic injury.

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