title: Self-expandable metal stent placement for treatment of severe sphincterotomy bleeding.
abstract: One of the most frequent complications of endoscopic sphincterotomy (ES) is bleeding. When post-ES bleeding does not respond to the use of typical endoscopic therapy, the only alternative is angiography or surgery. A 82-year-old female was admitted for jaundice. A RMN-cholangiography revealed multiple stones in the common bile duct (CBD). She underwent endoscopic retrograde cholangiopancreatography (ERCP). The papilla major was located between two large periampullary diverticula. During the ES, a severe bleeding was observed from the upper part of the biliary cut. Several methods of hemostasis (injection of adrenaline, thermal methods and balloon tamponate) were performed without efficacy. A partially covered metallic stent was placed across the biliary orifice, in order to compress mechanically the bleeding site archiving the hemostasis.
authors: Unit of Gastroenterology and Digestive Endoscopy and Anesthesiology and Reanimation, Sandro Pertini Hospital, Rome, Italy. maddyzip@yahoo.it
authors: M
authors: M
authors: Zippi
authors: I
authors: I
authors: De Felici
authors: R
authors: R
authors: Pica
authors: M A
authors: MA
authors: Agus
authors: A
authors: A
authors: Solinas
authors: G
authors: G
authors: Occhigrossi
authors: G
authors: G
authors: Traversa
mesh_terms: D000369:Aged, 80 and over; D016063:Blood Loss, Surgical; D002760:Cholangiopancreatography, Endoscopic Retrograde / Q000379:methods; D042883:Choledocholithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D005260:Female; D006801:Humans; D008670:Metals; D016717:Sphincterotomy, Endoscopic / Q000009:adverse effects*; D015607:Stents; D016896:Treatment Outcome
chemical_list: D008670:Metals