HEPATIC SUBCAPSULAR HEMATOMA AFTER ERCP: AN UNCOMMON BUT POTENTIALLY VERY SERIOUS COMPLICATION

Hepatic hematoma is an uncommon complication of ERCP, a potentially serious condition that requires specific treatment (surgery, embolization). A 37-year-old woman with choledocholithiasis underwent an ERCP with sphincterotomy and stone extraction, without incidents. 3 hours later she presented epigastric pain and anemization of 4 g of Hb. An urgent CT scan showed a left hepatic subcapsular hematoma of 14 × 6 cm, which compressed the hepatic surface, with gas bubbles in its deep portion, with no clear signs of active bleeding. Arteriography was decided without clear contrast extravasation points and empirical embolization was performed with Espongostan with good angiographic results, being discharged few days later.