Late-onset severe biliary bleeding after endoscopic pigtail plastic stent insertion

World J Gastroenterol. 2017 Jan 28;23(4):735-739. doi: 10.3748/wjg.v23.i4.735.

Abstract

Here, we report our experience with a case of severe biliary bleeding due to a hepatic arterial pseudoaneurysm that had developed 1 year after endoscopic biliary plastic stent insertion. The patient, a 78-year-old woman, presented with hematemesis and obstructive jaundice. Ruptured hepatic arterial pseudoaneurysm was diagnosed, which was suspected to have been caused by long-term placement of an endoscopic retrograde biliary drainage (ERBD) stent. This episode of biliary bleeding was successfully treated by transarterial embolization (TAE). Pseudoaneurysm leading to hemobilia is a rare but potentially fatal complication in patients with long-term placement of ERBD. TAE is a minimally invasive procedure that offers effective treatment for biliary bleeding.

Keywords: Biliary bleeding; Biliary stent; Pigtail stent; Plastic stent; Pseudoaneurysm.

MeSH terms

  • Aged
  • Aneurysm, False
  • Biliary Tract / pathology*
  • Cholangiopancreatography, Endoscopic Retrograde / adverse effects
  • Computed Tomography Angiography
  • Drainage / methods
  • Embolization, Therapeutic / methods
  • Female
  • Hematemesis
  • Hemobilia / etiology
  • Hemorrhage
  • Hepatic Artery / pathology*
  • Humans
  • Incidence
  • Jaundice, Obstructive / diagnosis
  • Plastics / adverse effects*
  • Prosthesis Implantation / adverse effects
  • Stents / adverse effects*
  • Time Factors
  • Treatment Outcome

Substances

  • Plastics