title: A dangerous loop.
abstract: A 76-year-old man developed a hemoperitoneum after ERCP for choledocholithiasis. He underwent a laparotomy and splenectomy for a capsular tear at the splenic hilum, a rare complication of ERCP. "Bowing" of the endoscope with torsion on the greater curvature of the stomach may lead to shear forces causing splenic injury.
authors.affiliation: Gastroenterology National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK.
authors.forename: Saqib
authors.initials: S
authors.lastname: Ahmad
authors.affiliation: Gastrointestinal Surgery National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK.
authors.forename: Damian
authors.initials: D
authors.lastname: Bragg
authors.affiliation: Cellular Pathology National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK.
authors.forename: Abed M
authors.initials: AM
authors.lastname: Zaitoun
authors.affiliation: Gastrointestinal Surgery National Institute for Health Research Nottingham Digestive Diseases Biomedical Research Unit Nottingham University Hospitals and University of Nottingham Queen's Medical Centre Nottingham UK.
authors.forename: Dileep N
authors.initials: DN
authors.lastname: Lobo
keywords: Adverse event; ERCP; hemorrhage; imaging; splenic injury; surgery