A case of bile duct variceal bleeding successfully managed with a fully-covered self-expandable metal stent

Abstract

A 75-year-old woman developed portal vein thrombosis following a laparoscopic cholecystectomy for a gallbladder adenoma and was managed with anticoagulant therapy. Approximately two months post-surgery, she presented to the emergency department with hematemesis. Contrast-enhanced CT revealed no active bleeding, but cavernous transformation was noted. EGD showed minor bleeding from the duodenal papilla, and ERCP was performed for suspected haemobilia. Upon insertion of a contrast catheter into the bile duct, significant hemorrhage was observed. Cholangiography identified collateral vessels around the bile duct, leading to a diagnosis of bleeding from common bile duct varices.

Hemostasis was achieved by placing a fully-covered self-expandable metal stent to compress the varices. Although rare, common bile duct variceal bleeding should be considered in patients with portal hypertension.