Letters To The Editor
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World J Gastroenterol. Dec 14, 2011; 17(46): 5131-5132
Published online Dec 14, 2011. doi: 10.3748/wjg.v17.i46.5131
Portal vein cannulation: An uncommon complication of endoscopic retrograde cholangiopancreatography
Evangelos Kalaitzakis, Nicholas Stern, Richard Sturgess
Evangelos Kalaitzakis, Nicholas Stern, Richard Sturgess, Digestive Disease Unit, Department of Gastroenterology, Aintree University Hospitals, Liverpool, L9 7AL, United Kingdom
Author contributions: Kalaitzakis E drafted the paper; all authors contributed to conception and analysis of clinical data, critical revision of the draft, and approval of the final version of the paper; and Sturgess R contributed to supervision.
Correspondence to: Evangelos Kalaitzakis, MD, PhD, Digestive Disease Unit, Department of Gastroenterology, Aintree University Hospitals, Liverpool, L9 7AL, United Kingdom. evangelos.kalaitzakis@medicine.gu.se
Telephone: +44-151-5298157 Fax: +44-151-5292490
Received: April 6, 2011
Revised: July 6, 2011
Accepted: July 13, 2011
Published online: December 14, 2011
Abstract

Portal vein cannulation is a rare complication of endoscopic retrograde cholangiopancreatography (ERCP). It has been reported that it usually occurs after endoscopic sphincterotomy, whereas in cases without prior sphincterotomy, the presence of portobiliary fistulas has been shown. Here, we present a case in which cannulation of the portal vein occurred despite careful wire-guided cannulation and the absence of sphincterotomy. Although fatal cases of cerebral and pulmonary air and/or bile embolism have been reported in patients with combined portal and hepatic vein trauma after ERCP and sphincterotomy, isolated portal vein cannulation, as in the current case, does not usually result in mortality or serious morbidity. However, awareness of this rare complication is important so that no further intervention is performed.

Keywords: Endoscopic retrograde cholangiopancreatography; Complications; Portal vein cannulation