Self-expandable metal stent placement for treatment of severe sphincterotomy bleeding

One of the most frequent complications of endoscopic sphincterotomy (ES) is bleeding. When post-ES bleeding does not respond to the use of typical endoscopic therapy, the only alternative is angiography or surgery. A 82-year-old female was admitted for jaundice. A RMN-cholangiography revealed multip...

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Bibliographic Details
Published inClinica terapeutica Vol. 164; no. 1; p. e27
Main Authors Zippi, M, De Felici, I, Pica, R, Agus, M A, Solinas, A, Occhigrossi, G, Traversa, G
Format Journal Article
LanguageEnglish
Published Italy 2013
Subjects
Aged, 80 and over
Blood Loss, Surgical
Cholangiopancreatography, Endoscopic Retrograde - methods
Choledocholithiasis - diagnostic imaging
Choledocholithiasis - surgery
Female
Humans
Metals
Sphincterotomy, Endoscopic - adverse effects
Stents
Treatment Outcome
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Summary:One of the most frequent complications of endoscopic sphincterotomy (ES) is bleeding. When post-ES bleeding does not respond to the use of typical endoscopic therapy, the only alternative is angiography or surgery. A 82-year-old female was admitted for jaundice. A RMN-cholangiography revealed multiple stones in the common bile duct (CBD). She underwent endoscopic retrograde cholangiopancreatography (ERCP). The papilla major was located between two large periampullary diverticula. During the ES, a severe bleeding was observed from the upper part of the biliary cut. Several methods of hemostasis (injection of adrenaline, thermal methods and balloon tamponate) were performed without efficacy. A partially covered metallic stent was placed across the biliary orifice, in order to compress mechanically the bleeding site archiving the hemostasis.
ISSN:1972-6007
DOI:10.7417/CT.2013.1517