medigraphic.com
ISSN 2594-1518 (Electronic)
ISSN 1405-0099 (Print)

2012, Number 3

<< Back

Cir Gen 2012; 34 (3)

Ruptured hepatic subcapsular hematoma and hypovolemic shock as an unusual complication after endoscopic retrograde cholangiopancreatography. Report of one case

Bartolo REF, Endoqui AY, Trejo SJ, Esperón LI, Dávila JH, Álvarez OJ, Montero LA, Ramos XR

Language: Spanish
References: 19
Page: 217-220
PDF size: 131.08 Kb.


ABSTRACT

Objective: To describe a case of ruptured hepatic subcapsular hematoma accompanied by hypovolemic shock as an unusual complication secondary to an endoscopic retrograde cholangiopancreatography.
Setting: Second level health care hospital. General Hospital Xoco, Mexico City.
Design: Case report.
Description of the case: A 66-year old woman, who was admitted through the emergency ward with a diagnosis of choledocholithiasis, and who was subjected to endoscopic retrograde cholangiopancreatography, performed 24 h after admission, confirming the presence of stones in the choledochus, observing discharge of purulent matter from the biliary tract; during the event, she presented desaturation, needing mechanical handling of the airways and intensive therapy management, with mainly ventilatory alterations. Twenty-four hours afterwards she presented a state of shock of sudden onset together with acute abdomen; surgical management was then decided, evidencing a ruptured hepatic subcapsular hematoma with 2000 ml of hemoperitoneum. Patient presenting complications due to hypovolemic state, ventilatory alterations, infectious focus in the biliary tract that lead to fatal outcome.
Conclusion: A subcapsular hematoma related to endoscopic retrograde cholangiopancreatography is an infrequent entity; this is the 14th reported case and the first with rupture.


REFERENCES

  1. Loeb PM, Wheeler HO, Berk RN. Endoscopic pancreatocholangiography in the diagnosis of biliary tract disease. Surg Clin North Am 1973; 53: 1007-1018.

  2. McCune WS, Shorb PE, Moscowitz H. Endoscopic cannulation of the ampulla of vater: a preliminary report. Ann Surg 1968; 167: 752-756.

  3. Barkay O, Fogel EL, Watkins JL, McHenry L, Lehman GA, Sherman S. Endoscopic retrograde pancreatography. Clin Gastroenterol Hepatol 2009; 7: 931-943.

  4. Ponce García J. Tratamiento de las enfermedades gastroenterológicas. 2da edición. España; Sociedad Española de Gastroenterología: 2006. Disponible en http://www.manualgastro.es/manualgastro/

  5. Rodríguez Muñoz, S. Hacia una CPRE más segura: selección, experiencia y profilaxis. Rev Esp Enferm Dig 2004; 96: 155-162.

  6. García-Cano Lizcano J, González Martin JA, Morillas Arino J, Perez Sola A. Complicaciones de la colangiopancreatografía retrógrada endoscópica: estudio en una unidad pequeña de CPRE. Rev Esp Enferm Dig 2004; 96: 163-173.

  7. Ortega Deballon P, Fernández Lobato R, García Septiem J, Nieves Vázquez MA, Martínez Santos C, Moreno Azcoita M. Liver hematoma following endoscopic retrograde cholangiopancreatography (ERCP). Surg Endosc 2000; 14: 767.

  8. Horn TL, Peña LR. Subcapsular hepatic hematoma after ERCP: case report and review. Gastrointest Endosc 2004; 59: 594-596.

  9. Chi KD, Waxman I. Subcapsular hepatic hematoma after guide wire injury during endoscopic retrograde cholangiopancreatography: management and review. Endoscopy 2004; 36: 1019-1021.

  10. Ertugrul I, Parlak E, Mehment I, Altiparmak E, Saşman N, abin B. An unusual complication of endoscopic retrograde cholangiopancreatography. Dig Dis Sci 2006; 51:1167–1168.

  11. Bhati CS, Inston N, Wigmore SJ. Subcapsular intrahepatic hematoma: an unusual complication of ERCP. Endoscopy 2007; 39: 150.

  12. Priego P, Rodríguez G, Mena A, Losa N, Aguilera A, Ramiro C, et al. Hematoma subcapsular hepático tras CPRE. Rev Esp Enf Ap Dig 2007; 99: 53-54.

  13. Petit-Laurent F, Scalone O, Penigaud M, Barbeys J. Hématome sous-capsulaire hépatique après cholangiopancréatographie retrograde endoscopique: description d’un cas clinique et revue de literature. Gastroenterol Clin Biol 2007; 31: 750-752.

  14. Papachristou GI, Baron TH. Complication of therapeutic endoscopic retrograde cholangiopancreatography. Gut 2007; 56: 854.

  15. Del Rosi M, Martinez Briceño Y, Louis Pérez CE, Garassini ChM. Hematoma intrahepático y subcapsular posterior a colangiopancreatografía retrógrada endoscópica (CPRE). Reporte de un caso y revisión. GEN 2007; 61: 210-211.

  16. de Mayo T, Vargas F, Castro M. Omalgia post CPRE. Rev chil radiol 2008; 14: 231-232.

  17. De La Serna-Higuera C, Fuentes Coronel A, Rodríguez Gómez SJ, Martin Arribas MI. Hematoma hepático subcapsular secundario al empleo de una guía hidrofílica durante una colangiopancreatografía retrógrada endoscópica. Gastroenterol Hepatol 2008; 31: 266-267.

  18. McArthur KS, Mills PR. Subcapsular hepatic hematoma after ERCP. Gastrointest Endoscopy 2008; 67: 379-380.

  19. Nari GA, Preciado Vargas J, Rosendo Ballesteros N. Una rara complicación de la CPRE: el hematoma subcapsular hepático. Cir Esp 2009; 85: 261-262.




2020     |     www.medigraphic.com