Ma ZW, Gong XJ, Chen YJ, Wang B. Vascular anomaly as a cause of late bleeding after endoscopic retrograde cholangiopancreatography: A case report. World J Gastrointest Endosc 2025; 17(8): 111141 [DOI: 10.4253/wjge.v17.i8.111141]
Corresponding Author of This Article
Bing Wang, MD, Associate Professor, Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430033, Hubei Province, China. t0013008@aliyun.com
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/
World J Gastrointest Endosc. Aug 16, 2025; 17(8): 111141 Published online Aug 16, 2025. doi: 10.4253/wjge.v17.i8.111141
Vascular anomaly as a cause of late bleeding after endoscopic retrograde cholangiopancreatography: A case report
Zhen-Wei Ma, Xiao-Jun Gong, Yong-Jun Chen, Bing Wang
Zhen-Wei Ma, Xiao-Jun Gong, Department of General Surgery, The Fifth Hospital of Wuhan, Wuhan 430000, Hubei Province, China
Yong-Jun Chen, Bing Wang, Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan 430033, Hubei Province, China
Author contributions: Ma ZW wrote the manuscript; Gong XJ and Chen YJ supervised the entire project; Wang B conceived the idea and designed the study; all authors read and approved the final manuscript.
Informed consent statement: Informed written consent was obtained from the patient for publication of this report and any accompanying images.
Conflict-of-interest statement: The authors declare no competing financial interests.
CARE Checklist (2016) statement: The authors have read the CARE Checklist (2016), and the manuscript was prepared and revised according to the CARE Checklist (2016).
Open Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (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: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bing Wang, MD, Associate Professor, Department of Biliary-Pancreatic Surgery, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, No. 1095 Jiefang Avenue, Wuhan 430033, Hubei Province, China. t0013008@aliyun.com
Received: June 24, 2025 Revised: July 8, 2025 Accepted: August 4, 2025 Published online: August 16, 2025 Processing time: 52 Days and 14.2 Hours
Abstract
BACKGROUND
Post-endoscopic retrograde cholangiopancreatography (ERCP) bleeding is a serious complication, and related case reports have described various bleeding events following ERCP, including injury to the right gastroepiploic artery, bleeding from biliary varices, retroperitoneal hematoma in liver transplant recipients and subcapsular liver hematoma after ERCP.
CASE SUMMARY
We present a case of a 55-year-old male patient who developed post-ERCP hemorrhage one month after undergoing ERCP, endoscopic sphincterotomy, and bile duct stone removal for acute biliary pancreatitis. The patient presented with upper abdominal pain and melena, and imaging studies revealed high-density shadows in the intrahepatic bile duct, gallbladder, and lower segment of the common bile duct, suggestive of bleeding. Emergency interventional embolization was performed, and subsequent endoscopic and interventional therapies were implemented to control the bleeding. The patient’s hemoglobin levels gradually improved, and biliary indicators normalized.
CONCLUSION
Post-ERCP bleeding can result from various etiologies, and the rupture of variant vessels is a noteworthy topic warranting further exploration.
Core Tip: This case report describes a 55-year-old male patient who experienced post-endoscopic retrograde cholangiopancreatography (ERCP) hemorrhage one month after undergoing ERCP, endoscopic sphincterotomy, and bile duct stone removal for acute biliary pancreatitis. The patient presented with upper abdominal pain and melena, and imaging studies revealed high-density shadows suggestive of bleeding. Emergency interventional embolization and subsequent endoscopic and interventional therapies were successful in controlling the bleeding, highlighting the importance of recognizing and managing various etiologies of post-ERCP bleeding, including the rupture of variant vessels.
