Portal cavernography during endoscopic retrograde cholangiopancreatography: from bilhemia to hemobilia

Abstract

Portobiliary fistulas are rare but may lead to life-threatening complications. Biliary plastic stent-induced portobiliary fistulas during endoscopic retrograde cholangiopancreatography have been described. Herein, we present a case of portal cavernography and recurrent hemobilia after endoscopic retrograde cholangiopancreatography in which a portobiliary fistula was detected in a patient with portal biliopathy. This likely indicates a change in clinical presentation (from bilhemia to hemobilia) after biliary drainage that was successfully treated by placement of a fully covered, self-expandable metallic stent.

Keywords

• endoscopic retrograde cholangiopancreatography
• hemobilia
• portal cavernography
• portobiliary fistula