Endoscopy 2025; 57(S 02): S304-S305
DOI: 10.1055/s-0045-1805745
Abstracts | ESGE Days 2025
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The First Case of Subcapsular Liver Hematoma Following Cholangioscopy in the Literature

Authors

  • H Eruzun

    1   Samsun Training and Research Hospital, Department of Gastroenterology, Samsun, Türkiye
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A 69-year-old female patient presented with painless jaundice. She had direct hyperbilirubinemia. Abdominal CT revealed significantly dilated bile ducts, with no stones detected. MRCP showed a suspected stricture in the mid-distal portion of the common bile duct (CBD). A biopsy was taken from the narrowed area of the CBD using EUS. During ERCP, a stricture approximately 15 mm in length was visualized in the mid-distal portion of the CBD, and an 8.5 F plastic biliary stent was placed. Since the biopsy taken during EUS was non-diagnostic, a cholangioscopy-guided biopsy was planned. The previously placed stent was removed, and a cholangioscope was used to visualize the stricture in the mid-portion of the CBD. The area appeared raised, vascular, and fragile, from which multiple biopsies were obtained. A new 10 F plastic biliary stent was placed via a guidewire. About 18 hours after the procedure, the patient developed nausea and left shoulder pain. She became hypotensive, and a 2.5-unit drop in hemoglobin was noted. CT confirmed a hematoma with air densities in the right lobe of the liver. Her hemoglobin levels remained stable, but due to worsening pain, a repeat CT scan showed the hematoma had increased in size to 13 mm. Given the patient’s persistent pain despite stable hemodynamics, a drain was placed into the hematoma area by interventional radiology, which yielded hemorrhagic fluid, leading to pain relief. The biopsy from the cholangioscopy revealed high-grade dysplasia in the CBD. The patient was referred to general surgery for operative management [1] [2].



Publication History

Article published online:
27 March 2025

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  • References

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