Published online Jan 28, 2017. doi: 10.3748/wjg.v23.i4.735
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
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.