Splenic subcapsular hematoma following endoscopic retrograde cholangiopancreatography: A case report and review of literature

World J Clin Cases. 2024 Aug 26;12(24):5613-5621. doi: 10.12998/wjcc.v12.i24.5613.

Abstract

Background: Splenic injury following endoscopic retrograde cholangiopancreatography (ERCP) is a rare complication. The literature contains around 30 articles reporting various degrees of splenic injuries resulting from ERCP since the first report of splenic rupture after ERCP in 1989.

Case summary: This report describes a case of splenic hematoma and stent displacement in a 69-year-old male patient who developed these conditions 7 days after undergoing ERCP and stenting. The patient had bile duct stenosis caused by a malignant tumor that was obstructing the bile duct. The diagnosis was confirmed by epigastric computed tomography and magnetic resonance cholangiopancreatography. The patient was successfully treated with percutaneous transhepatic cholangial drainage, endoscopic pyloric stent placement, and conservative management. The causes of splenic injury following ERCP are discussed.

Conclusion: ERCP has the potential to cause splenic injury. If a patient experiences symptoms such as abdominal pain, decreased blood pressure, and altered hematology after the procedure, it's important to be thoroughly investigated for postoperative bleeding and splenic injury.

Keywords: Case report; Endoscopic retrograde cholangiopancreatography; Gastroenterology; Hematoma; Splenic injury.

Publication types

  • Case Reports