Korean J Med.  2014 Apr;86(4):462-465.

Portal Vein Cannulation During Endoscopic Retrograde Cholangiopancreatography

• Kim CL
• Ha Y
• Om SY
• Ji W
• Kim TO
• Choi JH
• Kim MH

Abstract

A 68-year-old woman was admitted to our hospital with obstructive jaundice. Abdominal CT scan demonstrated a mass at the head of the pancreas. The patient was diagnosed as having obstructive jaundice caused by pancreatic cancer. We tried to relieve the bile duct obstruction by ERCP (endoscopic retrograde cholangiopancreatography). After several cannulation attempts, we thought that we had achieved deep cannulation of the bile duct and tried to place a biliary plastic stent. During ERCP, however, we noticed massive air in the portal venous system, indicating possible cannulation of the portal vein. The procedure was terminated immediately and abdominal computed tomography revealed air in the portal venous system. Fortunately, there were no subsequent complications. The air in the portal vein had disappeared, ascertained by CT scan taken 5 days later. The patient underwent surgical resection for pancreatic cancer. Isolated portal vein cannulation per se does not usually result in mortality or serious morbidity.

Keyword

ERCP; Complications; Portal vein

MeSH Terms

Aged
Bile Ducts
Catheterization*
Cholangiopancreatography, Endoscopic Retrograde*
Cholestasis
Female
Head
Humans
Jaundice, Obstructive
Mortality
Pancreas
Pancreatic Neoplasms
Plastics
Portal Vein*
Stents
Tomography, X-Ray Computed
Plastics