Introduction:

Hepatic hematoma is a rare and life-threatening complication of endoscopic retrograde cholangiopancreatography (ERCP) that can be underdiagnosed in many cases.

Objective:

Communicate the case of an unusual ERCP complication in order to acknowledge this pathology at an early stage and avoid clinical deterioration of the patient.

Case report:

We present the case of a 35-year-old patient with a history of choledocholithiasis, who was admitted for cholangitis diagnosed by clinical and magnetic cholangioresonance (MCR) findings, for which ERCP was performed with balloon extraction. Eight hours after performing ERCP, the patient developed hemodynamic repercussions and a new laboratory analysis showed an evident decrease in hemoglobin to 6.4 g/dl. The abdominopelvic computed tomography (CT) showed a hematoma of approximately 60% of the liver morphology, for which an emergency surgical approach was decisive.

Conclusion:

Post-ERCP liver hematoma is a rare and potentially serious complication. Most hematomas are solved with a conservative treatment, leaving surgery as the last option in patients with critical evolution.

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