Splenic artery rupture and bleeding following endoscopic retrograde cholangiopancreatography: A case report.

INTRODUCTION: Common complications after endoscopic retrograde cholangiopancreatography (ERCP) include acute pancreatitis, gastrointestinal perforation or bleeding, while splenic artery rupture and bleeding is a very rare complication. MAIN SYMPTOMS: This study reports a case of splenic artery rupture and bleeding after ERCP, providing reference experience for clinicians. This article describes the case of a 67-year-old patient who underwent ERCP to alleviate jaundice associated with pancreatic head cancer. During the procedure, the patient experienced unexpected hemorrhagic shock. DIAGNOSES, INTERVENTIONS, AND OUTCOME: The shock was later confirmed as distal splenic artery (short gastric artery) bleeding by digital subtraction angiography, without splenic capsule tearing or subcapsular hematoma. Distal splenic artery branch embolization was performed immediately to avoid splenectomy, and satisfactory results were achieved. CONCLUSION: Splenic artery bleeding is an unexpected and extremely rare complication after ERCP and distal splenic artery branch embolization with digital subtraction angiography is a possible treatment approach. This case provides physicians with valuable experience, highlighting the importance of being highly suspicious of such rare complications, and discussing the possible causes and treatment methods for splenic injury following ERCP.