Rare Complication of a Subcapsular Hepatic Biloma Following Endoscopic Retrograde Cholangiopancreatography for Choledocholithiasis

A subcapsular biloma is an uncommon but potentially serious complication of endoscopic retrograde cholangiopancreatography (ERCP). We present the case of a middle-aged woman who developed a symptomatic subcapsular hepatic biloma following ERCP for choledocholithiasis. She was treated with a combination of interventional radiology-guided drainage and repeat ERCP. Early imaging and close clinical monitoring were important to her recovery. This case underscores the importance of maintaining a significant suspicion for atypical post-ERCP presentations and intervening promptly to avoid complications.