Endoscopic Retrograde Cholangiopancreatography: A Rare Cause of Splenic Avulsion

Hamed Taheri, MD, Kalyan Vunnamadala, MD, Leopoldo Baccaro, MD, Artun Aksade, MD. Easton Hospital

BACKGROUND: Endoscopic Retrograde cholangiopancreatography (ERCP) is an extremely feasible diagnostic and therapeutic tool with few complications. Here we present a patient who was diagnosed with a splenic avulsion after undergoing ERCP. METHOD: Case presentation and liturature review for splenic injury caused by ERCP. A 55 year-old female who was found to have elevated liver function tests after laparoscopic cholecystectomy with intraoperative common bile duct (CBD) exploration. The patient underwent an ERCP with sphincterotomy six days after the operation for the persistently elevated liver function tests (suspicion of retained CBD stones). Post ERCP, she was found to have severe abdominal pain with signs and symptoms of hypovolemic shock. Splenic capsular avulsion with massive hemoperitoneum was seen on the computerized tomography scan of the abdomen. An urgent laparotomy confirmed splenic capsular avulsion. CONCLUSION: There are only ten case reports of splenic injuries post ERCP. This case is a rare example of splenic capsular avulsion.

Session: Poster
Program Number: P203
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