Hepatic subcapsular hematoma post-ERCP: Case report and literature review.

Autor: Pivetta, Luca Giovanni Antonio, da Costa Ferreira, Caroline Petersen, de Carvalho, João Paulo Venancio, Konichi, Renata Yumi Lima, Kawamoto, Victor Kenzo Fujikawa, Assef, Jose Cesar, Ribeiro, Mauricio Alves
Zdroj: International Journal of Surgery Case Reports; 2020, Vol. 72, p219-228, 10p
Abstrakt: • A case of hepatic subcapsular hematoma (HSH) rupture that required surgical treatment. • Sixty one cases of HSH were described in the literature, fourteen of them ruptured. • HSH rupture has a significant increase in the mortality (21.4% × 2.2%). • Conservative treatment may be the conduct for cases with non-ruptured hematomas. • HSH rupture required surgical intervention in 78.6% of cases. Endoscopic retrograde cholangiopancreatography (ERCP) is one of the most frequently performed minimally invasive procedures currently available for diagnosis and treatment of biliary and pancreatic diseases. Though considered a safe procedure, it has the highest rate of complications among the other endoscopic procedures, such as duodenal perforation and hepatic subcapsular hematoma (HSH). We are a presenting a case report and review of the current literature. We report one case HSH rupture, in a 25 years old female patient, 15 cm in diameter, affecting liver segments VI, VII and VIII, who underwent surgical treatment and performed a systematic literature review with the descriptors: endoscopic retrograde colangiopancreatography and hepatic subcapsular hematoma. All articles were reviewed and data on cases that presented rupture of the HSH analyzed separately. Sixty one cases of HSH were described in the literature, fourteen of them ruptured. When analyzing only the subgroup of patients who had ruptured subcapsular hematoma, we showed a significant increase in the mortality rate of patients when compared to non-ruptured (21.4% × 2.2%). We also report that patients with rupture required some type of intervention, of which 78.6% required surgery. Conservative treatment may be the conduct and will suffice for most cases of non-ruptured hematomas. For patients who evolve with rupturing, surgical resolution, although non-mandatory, is necessary in most cases. HSH ruptured is a rare and potentially fatal post-ERCP complication whose treatment is eminently surgical. [ABSTRACT FROM AUTHOR]
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