Delayed Severe Hemobilia after Endoscopic Biliary Plastic Stent Insertion.

Area of Science:

• Gastroenterology
• Interventional Endoscopy
• Vascular Interventions

Background:

• Hemobilia is a rare cause of gastrointestinal bleeding, often linked to bile duct injury.
• While typically self-limiting after endoscopic retrograde cholangiopancreatography (ERCP), severe and fatal hemorrhages can occur.
• Prompt management of ERCP-related perforations is crucial, depending on injury type and patient status.

Purpose of the Study:

• To report a case of late-onset severe hemobilia following ERCP.
• To highlight the successful management of this rare complication.

Main Methods:

• A case of late-onset severe hemobilia attributed to ERCP-related bile duct perforation was identified.
• The patient underwent endoscopic biliary stent insertion for treatment.
• Transarterial coil embolization was employed as a secondary treatment.

Main Results:

• The patient, who experienced hemobilia 5 weeks after ERCP-related perforation during stone removal, recovered following endoscopic biliary stent insertion.
• The bleeding was successfully controlled with two sessions of transarterial coil embolization.
• This case demonstrates a successful outcome for a rare and severe complication.

Conclusions:

• Late-onset severe hemobilia can occur after ERCP, even weeks after the initial procedure.
• Endoscopic biliary stent insertion and transarterial coil embolization are effective treatment modalities for managing ERCP-related hemobilia.
• Careful monitoring and prompt intervention are essential for patients with suspected ERCP-related complications.