A man in his sixties presented to our hospital with obstructive jaundice and was diagnosed with inoperable pancreatic cancer. Chemoradiotherapy was initiated, and an expandable metallic stent was inserted endoscopically to drain the biliary system. Six months later, he was referred to our hospital with 1-week history of epigastric pain and obstructive jaundice. On admission for further evaluation, he experienced hematemesis and went into severe shock. Upper gastrointestinal endoscopy and endoscopic retrograde cholangiopancreatography showed active bleeding from the duodenal papilla. Therefore, we performed endoscopic nasobiliary drainage (ENBD). On day 4, blood was detected in the ENBD tube, and the patient again experienced hematemesis. Emergent enhanced computed tomography revealed a right hepatic arterial aneurysm that had likely ruptured and caused the hemobilia. The aneurysm was successfully embolized, and the patient was discharged on hospital day 21.
Download full-text PDF |
Source |
---|
Introduction: Reports of pseudoaneurysms associated with biliary self-expandable metallic stent (SEMS) placement have been increasing. Recently, cases of hepatic pseudoaneurysm rupture caused by double pigtail plastic stents (DPS) have also been reported. The symptoms of pseudoaneurysms are often non-specific, and many cases are diagnosed only after rupture.
View Article and Find Full Text PDFCureus
December 2024
Professorial Surgical Unit, National Hospital of Sri Lanka, Colombo, LKA.
Sarcoidosis is a chronic granulomatous disease with multisystemic involvement with unspecified aetiology. Pancreatic involvement is a rare manifestation of systemic sarcoidosis and is often detected in postmortem studies. This clearly implies the rarity of the disease and its diagnostic challenges.
View Article and Find Full Text PDFEuroasian J Hepatogastroenterol
December 2024
Department of Gastroenterology and Hepatology, Kalinga Institute of Medical Sciences (KIMS), Bhubaneswar, Odisha, India.
Background And Objective: Obstructive jaundice (OJ) and acute cholangitis (AC) are common presentations of biliary obstruction. In Eastern India, data regarding the causes of OJ and AC are scarce. This study aimed to determine the etiological spectrum of OJ and AC in a tertiary center in Eastern India.
View Article and Find Full Text PDFWorld J Surg
January 2025
Management Office for Health Data, China Medical University and Hospital, Taichung, Taiwan.
Objectives: Acute liver failure poses a significant challenge in surgical critically ill patients. Treatments typically focus on physiological support and alleviation of hepatic insult. This study aims to evaluate the role of high-volume plasma exchange (HVPE) in surgical critically ill patients with medical jaundice and hepatic failure.
View Article and Find Full Text PDFInt J Surg Case Rep
January 2025
Department of Upper Gastrointestinal/Hepatobiliary Surgery, Western Hospital, Footscray, VIC 3011, Australia.
Introduction: Haemobilia causing obstructive jaundice is a rare complication with most occurrences reported post instrumentation e.g. endoscopic retrograde cholangiopancreatography (ERCP), percutaneous transhepatic cholangioagraphy (PTC) and, trans-cystic duct exploration or due to hepatic tree pseudoaneurysms.
View Article and Find Full Text PDFEnter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!