Korean J Pancreas Biliary Tract.  2015 Apr;20(2):99-104. 10.15279/kpba.2015.20.2.99.

Life-threatening Hemobilia following Removal of a Biliary Stent in a Patient with a Bile Leak

Affiliations
  • 1Department of Internal Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea. thlee9@schmc.ac.kr
  • 2Department of Interventional Radiology, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.
  • 3Department of General Surgery, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea.

Abstract

Biliary plastic stent induced life-threatening hemobilia is very rare. In this case, hemobilia seriously worsened following removal of a biliary stent, which had been placed for treatment of a postoperative bile leak in a patient who had undergone lateral liver segmentectomy for abdominal trauma. Following placement of the biliary stent, the bile leak improved, but hemobilia and cholangitis developed five days later. To manage the stent malfunction, we removed the biliary stent. However, life-threatening hemobilia developed immediately after removal. Endoscopic hemostasis was impossible; therefore, emergency angiographic embolization and stent graft were performed successfully. In such cases, angiographic embolization and stent-graft placement are effective diagnostic and therapeutic alternatives. When a patient develops hemobilia or cholangitis after biliary stent placement, endoscopists should pay special attention to remove the stent, which might exacerbate hemobilia.

Keyword

Bile leak; Hemobilia; Biliary stent; Angiography

MeSH Terms

Angiography
Bile*
Blood Vessel Prosthesis
Cholangitis
Emergencies
Hemobilia*
Hemostasis, Endoscopic
Humans
Liver
Mastectomy, Segmental
Plastics
Stents*
Plastics
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