Upper gastrointestinal hemorrhage secondary to erosion of a biliary Wallstent in a woman with pancreatic cancer.
A 77-year-old patient with unresectable pancreatic adenocarcinoma sustained a life-threatening, upper gastrointestinal hemorrhage 1 month after placement of a biliary Wallstent. Radiographic and endoscopic studies revealed a choledocho-arterio-enteric fistula caused by erosion of the stent through the posterior duodenal wall. The patient was treated successfully with arterial embolization. This represents an unusual case of arterial bleeding with choledocho-arterio-enteric fistulization into the duodenum subsequent to biliary stent erosion.
Dept. of Medicine, Hospital of the University of Pennsylvania, University of Pennsylvania School of Medicine, Philadelphia 19104-4283, USA.
M F
MF
Gardiner
W B
WB
Long
Z J
ZJ
Haskal
G R
GR
Lichtenstein
D000230:Adenocarcinoma / Q000473:pathology / Q000628:therapy*; D000368:Aged; D001651:Cholestasis, Extrahepatic / Q000628:therapy*; D004378:Duodenal Diseases / Q000209:etiology; D004386:Duodenum / Q000098:blood supply; D016145:Endoscopy, Digestive System; D019544:Equipment Failure Analysis; D005260:Female; D017219:Gastric Outlet Obstruction / Q000209:etiology; D006471:Gastrointestinal Hemorrhage / Q000209:etiology*; D006499:Hepatic Artery; D006801:Humans; D007412:Intestinal Fistula / Q000209:etiology; D009367:Neoplasm Staging; D010166:Palliative Care; D010190:Pancreatic Neoplasms / Q000473:pathology / Q000628:therapy*; D015607:Stents; D016157:Vascular Fistula / Q000209:etiology