Abstract
A 88-year-old man was referred to our hospital with jaundice. Obstructive jaundice was diagnosed following the biochemical examination on admission. Endoscopic retrograde cholangiopancreatography (ERCP) showed obstruction in the common bile duct and endoscopic sphincterotomy (EST), intraductal ultrasonography (IDUS), and endoscopic nasobiliary drainage (ENBD) was performed following ERCP. When ERCP was performed for stone removal after one week, bleeding was seen from the incision in the duodenal papilla. As an endoscopic hemostatic procedure was not effective, transcatherter arterial embolisation (TAE) was carried out. On the first attempt we used metallic coils for the embolic material and it was unsuccessful. The second TAE was perfomed with N-butyl-2-cyanoacrylate and achieved complete hemostasis. TAE is one of effective therapeutic maneuvers for post EST hemorrhage when endoscopic treatment has not been effective. Additionally, N-butyl-2-cyanoacrylate is considered one of the active embolic materials.
