E-ISSN: 1305-3612
Malpositioned endoscopically inserted biliary stent causing massive hematemesis managed with vascular plug and stenting
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Interventional Radiology - Technical Note
VOLUME: 27 ISSUE: 6
P: 789-791
November 2021

Malpositioned endoscopically inserted biliary stent causing massive hematemesis managed with vascular plug and stenting

Diagn Interv Radiol 2021;27(6):789-791
DOI: 10.5152/dir.2021.20776
Mark A. Reddick 1
Andrew J. Ceranske 1
Peiman Habibollahi 2
1. From the Division of Vascular and Interventional Radiology, Department of Radiology UT Southwestern Medical Center, Texas, USA
2. Department of Interventional Radiology MD Anderson Cancer Center, Houston, Texas, USA
No information available.
No information available
Received Date: 18.09.2020
Accepted Date: 17.11.2020
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ABSTRACT

A 46-year-old man with a history of hepatitis B cirrhosis and hepatocellular carcinoma (HCC) status post liver transplantation two years ago complicated by HCC recurrence and biliary stenosis presented with hypovolemic shock and melena one month after endoscopic exchange of plastic biliary stents. During endoscopic retrograde cholangiopancreatography, patient was found to have hemobilia and developed uncontrollable bleeding after a common bile duct (CBD) sweep managed by insertion of a stent-graft across major papilla into presumed CBD. The bleeding continued with subsequent negative angiography, and a computed tomography angiography showed malpositioned stent-graft between major papilla and inferior vena cava (IVC). This was successfully managed by the deployment of a vascular plug inside the stent graft and excluding it by deploying a stent across the affected area in IVC.