Yasuda M, Sato H, Koyama Y, Sakakida T, Kawakami T, Nishimura T, Fujii H, Nakatsugawa Y, Yamada S, Tomatsuri N, Okuyama Y, Kimura H, Ito T, Morishita H, Yoshida N. Late-onset severe biliary bleeding after endoscopic pigtail plastic stent insertion. World J Gastroenterol 2017; 23(4): 735-739 [PMID: 28216982 DOI: 10.3748/wjg.v23.i4.735]
Corresponding Author of This Article
Dr. Muneji Yasuda, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, 749 Hon-machi 15, Higashiyama-ward, Kyoto 605-0981, Japan. muneji0811@yahoo.co.jp
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Case Report
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan
Takaaki Ito, Hiroyuki Morishita, Department of Radiology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan
Author contributions: Yasuda M, Sato H, Koyama Y, Kawakami T and Yoshida N contributed to the acquisition of data and to the writing and revision of this manuscript; Fujii H performed PTBD; Ito T and Morishita H performed TAE; all other members equally contributed medical treatment.
Supported byJapanese Red Cross Kyoto Daiichi Hospital, Kyoto, Japan.
Institutional review board statement: This case report was exempt from the Institutional Review Board standards of Japanese Red Cross Kyoto Daiichi Hospital.
Informed consent statement: The patient involved in this study gave written informed consent authorizing use and disclosure of her protected health information.
Conflict-of-interest statement: All of the authors state that they have no conflicts of interests related to this article.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Dr. Muneji Yasuda, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, 749 Hon-machi 15, Higashiyama-ward, Kyoto 605-0981, Japan. muneji0811@yahoo.co.jp
Telephone: +81-75-5611121 Fax: +81-75-5616308
Received: October 11, 2016 Peer-review started: October 13, 2016 First decision: October 28, 2016 Revised: November 9, 2016 Accepted: November 23, 2016 Article in press: November 28, 2016 Published online: January 28, 2017 Processing time: 99 Days and 17.9 Hours
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.
Core tip: Biliary bleeding after endoscopic pigtail plastic stent insertion is a rare but potentially fatal complication. Transarterial embolization (TAE) is a minimally invasive procedure that offers effective treatment for pseudoaneurysm. We report here a case of biliary bleeding caused by long-term placement of a pigtail plastic stent, which was inserted without removal of common bile duct stones due to the patient’s age; the TAE treatment was successful. This case report will help similar patients yet to be encountered but likely to increase in number due to ageing of the world’s population.
