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Fig. 10 | Insights into Imaging

Fig. 10

From: Cross-sectional imaging of common and unusual complications after endoscopic retrograde cholangiopancreatography

Fig. 10

A 39-year-old male with previous Bismuth type II iatrogenic bile duct injury during laparoscopic cholecystectomy 10 months earlier, shown in a coronal thick-slab MR cholangiography (MRCP) image (thin arrows in a), which required immediate reintervention to remove the surgical clips plus temporary plastic biliary stenting. Note haematoma in the gallbladder fossa (§). Twenty-four hours after endoscopic positioning of the covered metallic biliary stent (b), he suffered from sudden abdominal pain, vomiting and hypotension, and unenhanced (c) CT images detected a large hyperattenuating subcapsular liver haematoma (*) and haemoperitoneum (+) attributed to guidewire manoeuvres, which progressed at repeated contrast-enhancement CT on the next day (d), thus dictating immediate surgical evacuation

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