Case Report
Copyright ©The Author(s) 2003. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Oct 15, 2003; 9(10): 2377-2378
Published online Oct 15, 2003. doi: 10.3748/wjg.v9.i10.2377
Potentially fatal haemobilia due to inappropriate use of an expanding biliary stent
Rakesh Rai, John Rose, Derek Manas
Rakesh Rai, Derek Manas, Hepatobiliary Surgery and Liver Transplant Unit, Freeman Hospital, Newcastle, UK
John Rose, Department of Interventional Radiology, Freeman Hospital, Newcastle, UK
Author contributions: All authors contributed equally to the work.
Correspondence to: Mr. Rakesh Rai, Flat-2, 108 St. Georges Terrace, Jesmond, Newcastle, NE22DP, UK. rai2000@hotmail.com
Telephone: +44-191-2818326
Received: May 12, 2003
Revised: August 12, 2003
Accepted: August 19, 2003
Published online: October 15, 2003
Abstract

AIM: To highlight the fatal complication caused by expanding biliary stents and the importance of avoiding use of expanding stent in potentially curable diseases.

METHODS: Arteriobiliary fistula is an uncommon cause of haemobilia. We describe a case of right hepatic artery pseudoaneurysm causing arteriobiliary fistula and presenting as severe malena and cholangitis, in a patient with a mesh metal biliary stent. The patient had lymphoma causing bile duct obstruction.

RESULTS: Gastroduodenoscopy failed to establish the exact source of bleeding and hepatic artery angiography and selective embolisation of the pseudo aneurysm successfully controlled the bleeding.

CONCLUSION: Bleeding from the pseudo aneurysm of the hepatic artery can be fatal. Mesh metal stents in biliary tree can cause this complication as demonstrated in this case. So mesh metal stent insertion should be avoided in potentially benign or in curable conditions. Difficulty in diagnosis and management is discussed along with the review of the literature.

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