Diagnostic and Interventional Radiology
Interventional Radiology - Technical Note

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

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

Diagn Interv Radiol 2021; 27: 789-791
DOI: 10.5152/dir.2021.20776
Read: 212 Downloads: 44 Published: 19 October 2021

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. 

You may cite this article as: Reddick MA, Ceranske A, Habibollahi P. Malpositioned endoscopically inserted biliary stent causing massive hematemesis managed with vascular plug and stenting. Diagn Interv Radiol 2021; 27:789–791.

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