Abstract

Spontaneous liver laceration is a rare event, which usually occurs in patients with some underlying liver pathology. Subcapsular hematoma is an uncommon but known complication post-ERCP. ERCP guidewire induced liver injuries typically present within 48 hours of the procedure. Here we describe the case of a 67-year male patient who developed a hepatic pseudoaneurysm which ruptured leading to grade IV liver laceration 5 days after ERCP. The patient was managed non surgically, with angiographic embolization of the feeding artery, and later drainage of the collected hematoma through two pigtail drains placed under CT guidance. Treatment modalities include conservative medical management, angiographic embolization of the bleeding vessel, percutaneous drainage of the hematoma, and surgical management. Good outcome can be achieved with an individualized management plan and a multidisciplinary approach.