A CASE OF SUBCAPSULAR HEPATIC HEMATOMA AFTER ERCP

Abstract

An 86-year-old woman with several common bile duct stones was hospitalized. She underwent ERCP for choledocholithiasis with lithotripsy and stone extraction four times. At 30 hours after the 4th procedure, the patient complained of right upper quadrant abdominal pain. A computed tomography scan was performed, and revealed a cystic lesion on the surface of the right lobe of the liver. The cystic lesion was demonstrated by percutaneous needle aspiration to be a subcapsular hepatic hematoma. Because she was apyrexial and hemodynamically stable, she was conservatively managed with a broad-spectrum antibiotic and gradually recovered. Subcapsular hepatic hematoma is an extremely rare complication of ERCP, but the occurrence of abdominal pain after ERCP should raise the suspicion of this complication.