Case 1: A 70-year-old woman was admitted for a common bile duct stone and underwent endoscopic retrograde cholangiopancreatography (ERCP). After endoscopic sphincterotomy (EST) and papillary large-balloon dilation, the stone was removed. Seven days later, she developed melena and anemia. Therefore, duodenoscopy was performed, which showed bleeding from the major papilla.
Case 2: A 60-year-old man was admitted for jaundice and bile duct dilation. Computed tomography showed bile duct dilation but no obstructive lesion. Therefore, ERCP was performed. Duodenoscopy showed enlarged oral protrusion of the major papilla. Bleeding occurred when EST was performed.
In both cases, red dichromatic imaging (RDI) afforded improved visualization of bleeding points, which appeared darker yellow than the surrounding blood. Hemostasis was achieved by hemoclip application. RDI was effective in affording visualization of post-EST bleeding.
