title: Subcapsular liver hematoma after Endoscopic Retrograde Cholangiopancreatography in a liver transplant recipient.
abstract: Endoscopic Retrograde Cholangiopancreatography (ERCP) is commonly performed in patients after liver transplantation. The most common indications for ERCP include treatment of bile leaks and anastomotic and nonanastomotic biliary strictures. In this report we describe an unusual complication of ERCP in a liver transplant recipient with a bile leak two months after orthotopic liver transplantation (OLT). After confirming a bile leak, a hydrophilic guide wire was placed in the intrahepatic duct, an endoscopic sphincterotomy was performed, and a biliary plastic stent was successfully placed over the wire across the bile leak. Within the following 24 hours the patient developed a sharp right-sided upper quadrant pain and a drop in his hemoglobin level. An abdominal CT scan demonstrated a subcapsular hepatic hematoma that was successfully managed conservatively.
authors.affiliation: GI/Endoscopy Unit, Institut de Malalties Digestives i Metaboliques, Hospital Clínic and University of Barcelona, Barcelona, Spain. acardena@clinic.ub.es
authors.forename: Andrés
authors.initials: A
authors.lastname: Cárdenas
authors.forename: Gonzalo
authors.initials: G
authors.lastname: Crespo
authors.forename: Domingo
authors.initials: D
authors.lastname: Balderramo
authors.forename: Josep P
authors.initials: JP
authors.lastname: Bordas
authors.forename: Oriol
authors.initials: O
authors.lastname: Sendino
authors.forename: Josep
authors.initials: J
authors.lastname: Llach
mesh_terms: D001660:Biliary Tract Diseases / Q000209:etiology / Q000601:surgery; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000009:adverse effects*; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006406:Hematoma / Q000209:etiology*; D006801:Humans; D008099:Liver / Q000473:pathology; D008103:Liver Cirrhosis / Q000601:surgery; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*