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Related Experiment Video

Updated: Mar 7, 2026

Endoscopic Ultrasound-Guided Biliary Drainage: Endoscopic Ultrasound-Guided Hepaticogastrostomy in Malignant Biliary Obstruction
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Late-onset severe biliary bleeding after endoscopic pigtail plastic stent insertion.

Muneji Yasuda1, Hideki Sato1, Yuki Koyama1

  • 1Muneji Yasuda, Hideki Sato, Yuki Koyama, Tomoki Sakakida, Takumi Kawakami, Takeshi Nishimura, Hideki Fujii, Yoshikazu Nakatsugawa, Shinya Yamada, Naoya Tomatsuri, Yusuke Okuyama, Hiroyuki Kimura, Norimasa Yoshida, Department of Gastroenterology and Hepatology, Japanese Red Cross Kyoto Daiichi Hospital, Kyoto 605-0981, Japan.

World Journal of Gastroenterology
|February 21, 2017
PubMed
Summary

Severe biliary bleeding from a hepatic arterial pseudoaneurysm, a rare complication of long-term endoscopic retrograde biliary drainage (ERBD) stents, was successfully treated with transarterial embolization (TAE).

Keywords:
Biliary bleedingBiliary stentPigtail stentPlastic stentPseudoaneurysm

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Area of Science:

  • Gastroenterology
  • Interventional Radiology
  • Vascular Surgery

Background:

  • Hepatic arterial pseudoaneurysms are rare but serious complications.
  • Long-term endoscopic retrograde biliary drainage (ERBD) stent placement can be a predisposing factor.
  • Biliary bleeding, or hemobilia, can be life-threatening.

Purpose of the Study:

  • To report a case of severe biliary bleeding caused by a hepatic arterial pseudoaneurysm.
  • To highlight the potential link between long-term ERBD stent placement and pseudoaneurysm formation.
  • To demonstrate the efficacy of transarterial embolization (TAE) in managing this complication.

Main Methods:

  • Case report of a 78-year-old female patient presenting with hematemesis and obstructive jaundice.
  • Diagnosis of a ruptured hepatic arterial pseudoaneurysm.
  • Treatment via transarterial embolization (TAE).

Main Results:

  • The patient experienced severe biliary bleeding due to a hepatic arterial pseudoaneurysm.
  • The pseudoaneurysm was suspected to be a consequence of a 1-year-old endoscopic biliary plastic stent.
  • Successful treatment of the biliary bleeding was achieved using TAE.

Conclusions:

  • Pseudoaneurysm formation leading to hemobilia is a rare, potentially fatal complication associated with long-term ERBD stent use.
  • Transarterial embolization (TAE) is an effective and minimally invasive treatment option for biliary bleeding caused by pseudoaneurysms.