Recognition and management of stent malposition in the portal vein during endoscopic retrograde cholangiopancreatography: A case report

Figure 1 Two plastic biliary stents (an 8. 5 F, 7 cm single external flap stent and a 7 F, 7 cm single pigtail stent) from previous endoscopic retrograde cholangiopancreatography. A: X-ray images; B: Endoscopic images.

Figure 2 Contrast-enhanced computed tomography. A: Contrast-enhanced computed tomography (CT) image showing that a biliary stent had entered the main portal vein; B: Contrast-enhanced CT images of the reconstructed portal vein; C: The single pigtail stent separated from the single flap stent and migrated straight up the spine into the portal vein; D: Repeated portal angiography showed no contrast leakage after placement of the fully covered metal stent in the common bile duct.

Figure 3 Repeat contrast-enhanced computed tomography scan showing portal vein thrombosis. A: Portal vein thrombosis occurred after endoscopic retrograde cholangiopancreatography; B: The portal vein thrombus appeared significantly smaller at the one-month follow-up exam; C: The portal vein thrombus was no longer present at the three-month follow-up exam.