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Updated: Aug 10, 2025
Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
Published on: March 25, 2022
CT guided percutaneous drainage for left hepatic subcapsular hematoma after endoscopic retrograde
Min Li1, Kangning Yu2, Denghao Deng3
1Dalian Medical University.
Insights
Endoscopic retrograde cholangiopancreatography (ERCP) can lead to rare left hepatic subcapsular hematomas. This case highlights successful CT-guided drainage of a post-ERCP hematoma in a young woman.
Area of Science:
- Gastroenterology
- Hepatology
- Interventional Radiology
Background:
- Endoscopic retrograde cholangiopancreatography (ERCP) is a standard procedure for biliary and pancreatic diseases.
- Common post-ERCP complications include pancreatitis, infection, bleeding, and perforation.
- Left hepatic subcapsular hematoma is a rare but serious complication following ERCP.
Observation:
- A 29-year-old woman developed a left hepatic subcapsular hematoma 56 hours after ERCP.
- Conservative treatment failed to improve her symptoms.
- The hematoma contained a mixture of blood and bile.
Findings:
- Diagnosis was confirmed via imaging.
- CT-guided percutaneous drainage was performed.
- Drainage output decreased significantly over five days, indicating resolution.
Implications:
- This case underscores the importance of considering rare complications like hepatic subcapsular hematoma after ERCP.
- CT-guided percutaneous drainage can be an effective treatment modality.
- Prompt diagnosis and intervention are crucial for managing potentially life-threatening post-ERCP complications.
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.
