Korean J Pancreas Biliary Tract.  2014 Apr;19(2):94-100.

A Case of Metabolic Encephalopathy Due to Bleeding after EPBD

  • 1Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea. drjaihwan@snubh.org
  • 2Seoul National University Hospital, Seoul, Korea.
  • 3Seoul National University Bundang Hospital, Seongnam, Korea.


Endoscopic retrograde cholangiopancreatography is widely used for diagnosis and treatment of pancreatobiliary diseases and associated with a spectrum of complications such as pancreatitis, hemorrhage, and so on. Endoscopic papillary balloon dilatation (EPBD) has an advantage over endoscopic sphincterotomy in complication of bleeding. We report here on a 68-year-old woman who developed metabolic encephalopathy due to massive bleeding after EPBD. Massive bleeding was controlled after selective embolization and metabolic encephalopathy was improved after conservative management. Metabolic encephalopathy due to massive bleeding after EPBD has not been reported. We report on this unusual case along with a review of the related literatures.


Endoscopic balloon dilatation; Endoscopic retrograde biliary drainage; Metabolic encephalopathy; Embolization; Bleeding
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