Resumo

ROSALES-FLORES, Jonathan  e  HERNANDEZ-SALAS, Luis A.. Subcapsular hepatic hematoma after endoscopic retrograde cholangiopancreatography. Endoscopia [online]. 2022, vol.34, n.3, pp.80-85.  Epub 08-Maio-2023. ISSN 2444-6483.  https://doi.org/10.24875/end.23000001.

Hepatic subcapsular hematoma (HSCH) is an after endoscopic retrograde cholangiopancreatography (ERCP) adverse event considered rare. A bibliographic search of cases of after-ERCP HSCH published from 2000 to 2022 in PubMed, Cochrane and Google was carried out. Including two of our own, 63 cases were collected and the available data were collected to propose a pathophysiological mechanism, description of the clinical picture, diagnosis, treatment, prevention and prognosis. From a possible puncture of the intrahepatic bile ducts with the metal guide, HSCH manifests more frequently within 72 hours concluded the endoscopic procedure, with abdominal pain, anemia, hypotension, and fever. Its diagnosis requires imaging studies. Conservative management is successful in 36% of cases, so there are other invasive therapeutic alternatives. A mortality rate of 5% makes it necessary to consider preventive strategies such as the use of short guidewires, 0.025 caliber, coated with polymers, blunt tips, locking systems, avoiding forced traction with the balloon, and the use of exclusively therapeutic ERCP.

Palavras-chave : Endoscopic retrograde cholangiopancreatography; Hematoma; Liver.

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