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Bleeding causing biliary obstruction after endoscopic sphincterotomy
1Department of Medicine, Montefiore Medical Center/Albert Einstein College of Medicine, Bronx, New York 10467, USA.
The American Journal of Gastroenterology
|April 1, 1997
Summary
Recurrent biliary obstruction after endoscopic sphincterotomy can be caused by blood clots. Promptly flushing the bile duct with heparin can resolve these clots, avoiding unnecessary stone removal procedures.
Area of Science:
- Gastroenterology
- Hepatobiliary Surgery
Background:
- Cholecystectomy and endoscopic sphincterotomy are common procedures for biliary tract issues.
- Recurrent biliary obstruction can occur post-procedure, necessitating further intervention.
Observation:
- A patient developed recurrent common bile duct obstruction following an extended endoscopic sphincterotomy.
- The obstruction was found to be caused by a blood clot within the common bile duct.
Findings:
- The blood clot was successfully removed using the Fogarty technique.
- Irrigation with heparin resolved the biliary obstruction.
- Minor hemobilia can mimic choledocholithiasis.
Implications:
- Following endoscopic sphincterotomy, flushing the bile duct should be considered before aggressive stone removal maneuvers.
- This approach may prevent complications and improve patient outcomes in managing post-sphincterotomy biliary obstruction.