Loeys-Dietz Syndrome Presenting as Hemorrhage From Arteriobiliary Fistula: Endoscopic Management of Hemostasis

Loeys-Dietz syndrome is a rare autosomal dominant connective tissue disorder with an increasing risk of vascular aneurysm formation and dissection. In this report, we discuss the novel therapeutic use of a fully covered metallic stent for management of severe refractory hemorrhage from arteriobiliary fistula in a case complicated with Loeys-Dietz Syndrome and post thoracic aneurysm repair. Recent history of pancreaticoduodenectomy added on the anatomy complexity, and embolization of hepatic artery branches proved unsuccessful. Hemostasis was achieved after a metallic stent placement in the common bile and hepatic duct via endoscopic retrograde cholangiopancreatography.