Ruptured Hepatic Subcapsular Hematoma as a Complication of Endoscopic Retrograde Cholangiopancreatography. A Case Report and Literature Review

This report describes the unusual case of a 59-year-old woman who presented a subcapsular hepatic hematoma (HH) affecting liver segments VII and VIII as a complication of Endoscopic Retrograde Cholangiopancreatography (ERCP). Due to hemodynamic instability, urgent surgical hemostasis and evacuation of the hematoma were performed. The most important clinical manifestations were acute abdominal pain and progressive anemia. The diagnosis is based on clinical findings and images, being computed tomography (CT) the gold standard for the definitive diagnosis. The patient was successfully treated and was discharged home on the 75th hospital day. During the six-month follow-up, no clinical or biochemical abnormalities were observed, and the imaging studies showed a progressive reduction in the size of the injuries. As a potentially life-threatening complication, subcapsular hepatic hematoma after ERCP must be considered in the differential diagnosis of symptomatic cases in the early period after ERCP.